title: Role of old antimicrobial agents in the management of urinary tract infection.
abstract: BACKGROUND
  Urinary tract infection (UTI) is a common infection worldwide. The increase in multidrug resistance together with the paucity of new antibiotics highlights the need for alternative antimicrobials for management of UTI. Among which are older antimicrobials that had been used in the past and now were stopped.
  
  
  METHODS
  In this article, we examine the evidence in literature for the value of use of various antimicrobial agents in UTI. We conducted systematic Pubmed search and journal literature review including early research work on older agents addressed in relation to recent clinical data. Antimicrobials reviewed include temocillin, fosfomycin, mecillinam, methenamine and cycloserine. We review mechanisms of action, spectrum of activity, effect on multidrug resistance, cure rates and patient tolerance. Expert commentary: Rational use of current agents and rehabilitation of older drugs will both be needed, combined with antibiotic stewardship, in order to contain the march of antibiotic resistance.
authors.affiliation: a Department of Medical Microbiology , Aberdeen Royal Infirmary , Aberdeen , UK.
authors.forename: Noha
authors.initials: N
authors.lastname: El Sakka
authors.affiliation: a Department of Medical Microbiology , Aberdeen Royal Infirmary , Aberdeen , UK.
authors.forename: Ian M
authors.initials: IM
authors.lastname: Gould
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000892:Anti-Infective Agents, Urinary / Q000494:pharmacology / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D008826:Microbial Sensitivity Tests; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D000892:Anti-Infective Agents, Urinary
keywords: Temocillin; cycloserine; fosfomycin; mandelic acid; mecillinam; methenamine; nitroxoline; urinary tract infection