The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

Treatment of Community-Acquired Uncomplicated Urinary Tract Infection

지역사회 단순 요로감염에서의 항생제 내성 및 최신 치료

  • Pai, Hyun-Joo (Division of Infectious Diseases, Hanyang University Hospital)
  • 배현주 (한양대학교병원 감염내과)
  • Published : 2011.12.01
⟨ Previous Next ⟩

Abstract

Acute uncomplicated urinary tract infections (UTI), episodes of cystitis or pyelonephritis that occur in healthy non-pregnant women with no functional or anatomic abnormalities of the urinary tract, are among the most commonly encountered bacterial infections. Unfortunately, there has been a recent trend of increasing resistance to antibiotics among uropathogens in many countries including Korea. The resistance rates of Escherichia coli from acute uncomplicated UTI during 2009 to ciprofloxacin (CIP), trimethoprim-sulfamethoxazole (SXT) and cefotaxime were 84.1%, 67.2% and 95.4%, respectively. Resistance both to SXT and CIP was detected in 10.6% of the E. coli isolates. Therefore, it is difficult to recommend the antibiotics which would not worsen the resistance problem and would be effective for community-acquired uncomplicated UTI as well. Considering the high resistance of uropathogens in Korea, several academic societies made the guideline for UTI, which will be briefly reviewed in this manuscript.

Keywords

References

  1. Hooton TM. Fluoroquinolones and resistance in the treatment of uncomplicated urinary tract infection. Int J Antimicrob Agents 2003;22(Suppl 2):S565-S572.
  2. Sobel JD, Kaye D. Urinary tract infections. In: Mandell GL, Bennett JE, Dolin R, eds. Madell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Chrchill Livingstone Elsevier, 2010:957-985.
  3. Wie SH, Choi SM, Lee DG, et al. Antibiotic sensitivity of the causative organisms and use of antibiotics in women with communityacquired acute pyelonephritis. Infect Dis 2002;34:353-359.
  4. Kim SW, Lee JY, Park WJ, Cho YH, Yoon MS. Antibiotic sensitivity to the causative organism of acute simple urinary tract infection for recent 3 years. Infect Dis 2000;32:380-387.
  5. Min HJ. Acute pyelonephritis; clinical study and consideration about inpatient therapy. Korean J Med 1998;55:232-244.
  6. Shin JH, Kim J, Wie SH, et al. Fluoroquinolone resistance in uncomplicated acute pyelonephritis: epidemiology and clinical impact. Microbiol Drug Resis (in press).
  7. Kim ME, Ha US, Cho YH. Prevalence of antimicrobial resistance among uropathogens causing acute uncomplicated cystitis in female outpatients in South Korea: a multicentre study in 2006. Int J Antimicrob Agents 2008;31(Suppl 1):S15-S18. https://doi.org/10.1016/j.ijantimicag.2007.07.043
  8. Johnson L, Sabel A, Burman WJ, et al. Emergence of fluoroquinolone resistance in outpatient urinary Escherichia coli isolates. Am J Med 2008;121:876-884. https://doi.org/10.1016/j.amjmed.2008.04.039
  9. Kahlmeter G. The ECO.SENS Project: a prospective, multinational, multicentre epidemiological survey of the prevalence and antimicrobial susceptibility of urinary tract pathogens: interim report. J Antimicrob Chemother 2000;46(Suppl 1):S15-S22. https://doi.org/10.1093/jac/46.suppl_1.15
  10. Hawkey PM, Jones AM. The changing epidemiology of resistance. J Antimicrob Chemother 2009;64(Suppl 1):i3-i10. https://doi.org/10.1093/jac/dkp256
  11. Stamey TA, Fair WR, Timothy MM, Millar MA, Mihara G, Lowery YC. Serum versus urinary antimicrobial concentrations in cure of urinary-tract infections. N Engl J Med 1974;291:1159-1163. https://doi.org/10.1056/NEJM197411282912204
  12. Masterton RG, Bochsler JA. High-dosage co-amoxiclav in a single dose versus 7 days of co-trimoxazole as treatment of uncomplicated lower urinary tract infection in women. J Antimicrob Chemother 1995;35:129-137. https://doi.org/10.1093/jac/35.1.129
  13. McCarty JM, Richard G, Huck W, et al. A randomized trial of short-course ciprofloxacin, ofloxacin, or trimethoprim/ sulfamethoxazole for the treatment of acute urinary tract infection in women: Ciprofloxacin Urinary Tract Infection Group. Am J Med 1999;106;292-299. https://doi.org/10.1016/S0002-9343(99)00026-1
  14. Fang GD, Brennen C, Wagener M, et al. Use of ciprofloxacin versus use of aminoglycosides for therapy of complicated urinary tract infection: prospective, randomized clinical and pharmacokinetic study. Antimicrob Agents Chemother 1991;35:1849-1855. https://doi.org/10.1128/AAC.35.9.1849
  15. Gupta K, Hooton TM, Naber KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis 2011;52: e103-e120. https://doi.org/10.1093/cid/ciq257
  16. Kim KY, Kim CS, Lim DH. The Ciprofloxacin Resistance Pattern of Escherichia coli Isolated from Female Patients with Communityacquired Urinary Tract Infection in the Jeonnam and Gwangju Region for the Recent 2-years. Korean J Urol 2008;49:540-548, http://dx.doi.org/10.4111/kju.2008.49.6.540.
  17. Lee SE, Choi H, Kim YK. A clinical study of oral fosfomycin (Fosmycin) in the treatment of lower urinary tract infection. Korean J Urol 1984;25:167-172.
  18. Ryu KH, Kim MK, Jeong YB. A recent study on the antimicrobial sensitivity of the organisms that cause urinary tract infection. Infect Chemother 2011;43:1-25, http://dx.doi.org/10.3947/ic. 2011.43.1.1
  19. Lee YW, Chang SK. Clinical efficacy of pivmecillinam (Selexid). Korean J Urol 1983;24:413-417.
  20. The Korean Society of Infectious Diseases; The Korean Society for Chemotherapy; Korean Association of Urogenital Tract Infection and Inflammation; The Korean Society of Clinical Microbiology. Clinical guideline for the diagnosis and treatment of urinary tract infections: asymptomatic bacteriuria, uncomplicated & complicated urinary tract infections, bacterial prostatitis. Infect Chemother 2011;43:1-25. https://doi.org/10.3947/ic.2011.43.1.1