title: Escherichia coli resistance in uncomplicated urinary tract infection: a model for determining when to change first-line empirical antibiotic choice.
abstract: Escherichia coli is typically the causative organism in uncomplicated urinary tract infection (UTI). Resistance rates of E. coli to trimethoprim/sulfamethoxazole (TMP/SMX) are increasing, exceeding 10% in many communities. Guidelines recommend using alternative treatments in these areas. Providers must reevaluate policies to include considerations for E. coli resistance. A model was developed, with cases for illustration, to help organizations determine the resistance rate threshold, where TMP/SMX is no longer first-line therapy. Using published data, a 19% to 21% threshold was derived, supporting a previous report of 22%. The model can aid decision makers updating internal policies to conform with guidelines for the treatment of uncomplicated UTI and to improve care.
authors.affiliation: Bayer Pharmaceuticals, Inc., West Haven, Connecticut, USA.
authors.forename: Eleanor M
authors.initials: EM
authors.lastname: Perfetto
authors.forename: Kathleen
authors.initials: K
authors.lastname: Gondek
mesh_terms: D000900:Anti-Bacterial Agents; D017281:Cost of Illness; D004363:Drug Utilization; D004926:Escherichia coli / Q000187:drug effects*; D004927:Escherichia coli Infections / Q000188:drug therapy* / Q000191:economics / Q000382:microbiology; D006801:Humans; D010818:Practice Patterns, Physicians'; D014296:Trimethoprim Resistance; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology / Q000627:therapeutic use; D014481:United States; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000191:economics / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination