Predictive value of antimicrobial susceptibility from previous urinary tract infection in the treatment of re-infection

Br J Gen Pract. 2010 Jul;60(576):511-3. doi: 10.3399/bjgp10X514765.

Abstract

Recurrent urinary tract infections are often re-infections; therefore, antimicrobial susceptibility test results from a previous episode may guide the empiric therapy in subsequent episodes. This analysis provides predictive values of the antimicrobial susceptibility of previous Escherichia coli isolates for the treatment of re-infections in routine clinical practice. If resistance to ampicillin, trimethoprim, or ciprofloxacin is detected, re-prescription within 3 months is imprudent. Susceptibility to nitrofurantoin, ciprofloxacin, or trimethoprim in a previous sample supports their prescription for a re-infection within 3 months and up to a year. Resistance to nitrofurantoin is low and, once detected, decays relatively quickly. Nitrofurantoin should be considered as a first-line agent for initial and repeat treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Infective Agents, Urinary / therapeutic use*
  • Drug Resistance, Bacterial
  • Escherichia coli Infections / microbiology
  • Escherichia coli Infections / prevention & control*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Secondary Prevention
  • Urinary Tract Infections / microbiology
  • Urinary Tract Infections / prevention & control*

Substances

  • Anti-Infective Agents, Urinary