Journal Article

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

R. Raz, B. Chazan, Y. Kennes, R. Colodner, E. Rottensterich, M. Dan, I. Lavi and W. Stamm

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 34, issue 9, pages 1165-1169
Published in print May 2002 | ISSN: 1058-4838
Published online May 2002 | e-ISSN: 1537-6591 | DOI: https://dx.doi.org/10.1086/339812
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

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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.

Journal Article.  2551 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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