Outcomes associated with trimethoprim/sulphamethoxazole (TMP/SMX) therapy in TMP/SMX resistant community-acquired UTI.
The increase in resistance rates to TMP/SMX among E. coli causing community-acquired UTI has resulted in consideration of alternative agents as first line therapy for these infections. However, there has been little study of the clinical significance of the in vitro trends in resistance which have been reported. We review studies that address the correlation between in vitro resistance to TMP/SMX and clinical outcome in uncomplicated UTI. From these data, it is clear that in vitro resistance does translate into therapeutic failure for 50-60% of patients with a TMP/SMX resistant uropathogen. Thus, it is reasonable to consider an agent other than TMP/SMX when the TMP/SMX resistance prevalence reaches 20%.
Allergy and Infectious Diseases, University of Washington, Box 356523, Seattle, WA, USA. kalg@u.washington.edu
Kalpana
K
Gupta
Walter E
WE
Stamm
D000892:Anti-Infective Agents, Urinary / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy*; D006801:Humans; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use*; D014552:Urinary Tract Infections / Q000188:drug therapy*
D000892:Anti-Infective Agents, Urinary; D015662:Trimethoprim, Sulfamethoxazole Drug Combination