Empiric Use of Trimethoprim‐Sulfamethoxazole (TMP‐SMX) in the Treatment of Women with Uncomplicated Urinary Tract Infections, in a Geographical Area with a High Prevalence of TMP‐SMX–Resistant Uropathogens | Zendy

Raanan Raz | Zendy; Bibiana Chazan | Zendy; Yoram Kennes | Zendy; Raul Colodner | Zendy; E. Rottensterich | Zendy; M. Dan | Zendy; I. Lavi | Zendy; Walter E. Stamm | Zendy

Open Access

Empiric Use of Trimethoprim‐Sulfamethoxazole (TMP‐SMX) in the Treatment of Women with Uncomplicated Urinary Tract Infections, in a Geographical Area with a High Prevalence of TMP‐SMX–Resistant Uropathogens

Author(s) -

Raanan Raz,

Bibiana Chazan,

Yoram Kennes,

Raul Colodner,

E. Rottensterich,

M. Dan,

I. Lavi,

Walter E. Stamm

Publication year - 2002

Publication title -

clinical infectious diseases

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 3.44

H-Index - 336

eISSN - 1537-6591

pISSN - 1058-4838

DOI - 10.1086/339812

Subject(s) - medicine , sulfamethoxazole , trimethoprim , urinary system , empiric treatment , empiric therapy , antibiotics , microbiology and biotechnology , pathology , alternative medicine , biology

This study evaluated whether trimethoprim-sulfamethoxazole (TMP-SMX) is effective for treatment of uncomplicated urinary tract infections (UTIs) due to TMP-SMX-resistant (TMP-SMX-R) pathogens. Healthy nonpregnant premenopausal women with symptomatic lower UTI were assessed for the presence of pyuria and bacteriuria; if either was present, a urine sample was cultured and TMP-SMX was prescribed. Clinical and microbiologic cure was assessed at days 5-9 and 28-42 after cessation of therapy. For 71%, of patients, cultures grew TMP-SMX-susceptible (TMP-SMX-S) microorganisms, and for 29%, cultures grew TMP-SMX-R organisms. Escherichia coli remained the predominant bacteria in both groups of cultures. At visit 2, microbiological cure had been achieved in 86% of the patients in the TMP-SMX-S group and 42% of those in the TMP-SMX-R group. Similar differences were found at visit 3 by clinical evaluation. Treatment with TMP-SMX of uncomplicated UTI caused by TMP-SMX-R microorganisms results in microbiologic and clinical failure. In high-resistance areas, TMP-SMX should not be the empiric drug of choice for uncomplicated UTI.

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