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Risk factors for community-acquired ciprofloxacin-resistant Escherichia coli urinary tract infection.
Ann Pharmacother. 2004 Jul-Aug; 38(7-8):1148-52.AP

Abstract

BACKGROUND

Fluoroquinolones are recommended for the empiric treatment of urinary tract infection (UTI) in communities in which uropathogen resistance to trimethoprim/sulfamethoxazole (TMP/SMX) is >or=10% to 20%. However, recent studies also have demonstrated an increase in the isolation of fluoroquinolone-resistant Escherichia coli. Identification of outpatients at increased risk for fluoroquinolone resistance would improve the selection of empiric treatment.

OBJECTIVE

To identify risk factors for community-acquired UTIs due to ciprofloxacin-resistant E. coli (CREC).

METHODS

All medical records from the University of California at San Francisco Medical Center from January to December 2001 were retrospectively reviewed to identify patients with community-acquired UTI due to CREC. Patients with community-acquired UTI due to ciprofloxacin-susceptible E. coli presenting during the same time period were randomly selected as the study group in a 1:2 ratio of case to controls.

RESULTS

Independent risk factors for CREC included recurrent UTI (OR 8.13) and prior exposure to fluoroquinolones (OR 30.35).

CONCLUSIONS

Fluoroquinolones continue to be appropriate empiric treatment in most patients with uncomplicated UTI. Nitrofurantoin or a cephalosporin may be better choices in patients with recurrent lower UTI and/or previous fluoroquinolone use.

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Authors+Show Affiliations

Killgore KM
Department of Clinical Pharmacy, University of California, San Francisco, CA 94143-0622, USA.
March KL
No affiliation info available
Guglielmo BJ
No affiliation info available

MeSH

Anti-Bacterial AgentsCiprofloxacinCommunity-Acquired InfectionsDrug Resistance, BacterialEscherichia coliEscherichia coli InfectionsFemaleHumansMaleMiddle AgedRetrospective StudiesRisk FactorsUrinary Tract Infections

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15150380

Citation

Killgore, Karla M., et al. "Risk Factors for Community-acquired Ciprofloxacin-resistant Escherichia Coli Urinary Tract Infection." The Annals of Pharmacotherapy, vol. 38, no. 7-8, 2004, pp. 1148-52.
Killgore KM, March KL, Guglielmo BJ. Risk factors for community-acquired ciprofloxacin-resistant Escherichia coli urinary tract infection. Ann Pharmacother. 2004;38(7-8):1148-52.
Killgore, K. M., March, K. L., & Guglielmo, B. J. (2004). Risk factors for community-acquired ciprofloxacin-resistant Escherichia coli urinary tract infection. The Annals of Pharmacotherapy, 38(7-8), 1148-52.
Killgore KM, March KL, Guglielmo BJ. Risk Factors for Community-acquired Ciprofloxacin-resistant Escherichia Coli Urinary Tract Infection. Ann Pharmacother. 2004 Jul-Aug;38(7-8):1148-52. PubMed PMID: 15150380.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for community-acquired ciprofloxacin-resistant Escherichia coli urinary tract infection. AU - Killgore,Karla M, AU - March,Kristi L, AU - Guglielmo,B Joseph, Y1 - 2004/05/18/ PY - 2004/5/20/pubmed PY - 2004/10/7/medline PY - 2004/5/20/entrez SP - 1148 EP - 52 JF - The Annals of pharmacotherapy JO - Ann Pharmacother VL - 38 IS - 7-8 N2 - BACKGROUND: Fluoroquinolones are recommended for the empiric treatment of urinary tract infection (UTI) in communities in which uropathogen resistance to trimethoprim/sulfamethoxazole (TMP/SMX) is >or=10% to 20%. However, recent studies also have demonstrated an increase in the isolation of fluoroquinolone-resistant Escherichia coli. Identification of outpatients at increased risk for fluoroquinolone resistance would improve the selection of empiric treatment. OBJECTIVE: To identify risk factors for community-acquired UTIs due to ciprofloxacin-resistant E. coli (CREC). METHODS: All medical records from the University of California at San Francisco Medical Center from January to December 2001 were retrospectively reviewed to identify patients with community-acquired UTI due to CREC. Patients with community-acquired UTI due to ciprofloxacin-susceptible E. coli presenting during the same time period were randomly selected as the study group in a 1:2 ratio of case to controls. RESULTS: Independent risk factors for CREC included recurrent UTI (OR 8.13) and prior exposure to fluoroquinolones (OR 30.35). CONCLUSIONS: Fluoroquinolones continue to be appropriate empiric treatment in most patients with uncomplicated UTI. Nitrofurantoin or a cephalosporin may be better choices in patients with recurrent lower UTI and/or previous fluoroquinolone use. SN - 1060-0280 UR - https://www.unboundmedicine.com/medline/citation/15150380/Risk_factors_for_community_acquired_ciprofloxacin_resistant_Escherichia_coli_urinary_tract_infection_ L2 - https://journals.sagepub.com/doi/10.1345/aph.1D622?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -