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PubMed1992

[Annual changes of bacteria isolated from urinary tract infections and their susceptibility to new quinolone agents].

Statistical analyses were conducted on bacterial strains isolated from the urine of patients with urinary tract infections (UTI) in the Department of Urology at Aichi Medical University from January 1988 through December 1991. The drug sensitivity of the bacterial strains isolated from patients with complicated UTI between 1988 and 1991 was analyzed and compared. Among the outpatients with uncomplicated UTI, a total of 352 strains were isolated. E. coli was isolated the most frequently (90.1%). Among the outpatients with complicated UTI, a total of 829 strains were isolated. Enterococcus sp. was isolated the most frequently (21.2%). P. aeruginosa and S. aureus showed a tendency to increase. Among the inpatients with complicated UTI, a total of 671 strains were isolated. Enterococcus sp. was isolated the most frequently (22.5%). P. aeruginosa and S. aureus showed a tendency to increase, while E. coli and Enterobacter sp. showed a tendency to decrease. E. coli was highly sensitive to all drugs except ampicillin (ABPC). Proteus sp. and Klebsiella sp. were highly sensitive to norfloxacin (NFLX). P. aeruginosa was highly sensitive to gentamicin (GM). The frequency of NFLX-sensitive P. aeruginosa significantly dropped from 84.6% to 40.9% among the outpatients (P < 0.01), and from 75.0% to 44.4% among inpatients (P < 0.05). S. aureus was highly sensitive only to minocycline (MINO). The frequency of NFLX-sensitive S. aureus significantly dropped from 66.6% to 23.3% among inpatients (P < 0.05). Enterococcus sp. was highly sensitive to ABPC and MINO. Of the new quinolones, tosufloxacin (TFLX) had the strongest antimicrobial activity followed by (ciprofloxacin) CPFX on all the bacterial strains tested.

Bacteria↗
PubMed1992

[The effect of granulocyte elastase inhibitor (urinastatin) vaginal suppository on patients with imminent premature delivery].

Cervical maturation, dilatation and uterine contraction in imminent premature delivery are closely related to chemical mediators from activated granulocytes which infiltrate into the cervix. It is known that urinastatin (urinary trypsin inhibitor, UTI) inhibits many kinds of chemical mediators from granulocytes and macrophages such as granulocyte elastase (elastase) and interleukin 1. We examined the effect of a UTI suppository on uterine contraction and the elastase level in cervical mucus in cases of imminent premature delivery. We treated 43 cases of imminent premature delivery with tocolysis index 3 or 4 with 4 kinds of therapy: Group A (N = 12): ritodorine drop infusion therapy; Group B (N = 9): daily UTI suppository (1,000U) therapy; Group C (N = 14): daily UTI suppository + ritodorine drop infusion therapy; Group D: daily UTI suppository + ritodorine drop infusion + antibiotics (oral cepharosporine) therapy. The elastase level of cervical mucus before treatment was 0.76 +/- 0.40 micrograms/ml in group A, 0.93 +/- 0.43 micrograms/ml in group B, 0.85 +/- 0.40 micrograms/ml in group C and 0.90 +/- 0.41 micrograms/ml in group D. There was no significant difference between these groups. The elastase level in cervical mucus was 0.75 +/- 0.47 micrograms/ml in group A, 0.27 +/- 0.35 micrograms/ml in group B, 0.27 +/- 0.33 micrograms/ml in group C and 0.30 +/- 0.19 micrograms/ml in group D, respectively. The elastase level was decreased significantly in groups B, C and D. The time taken to depress uterine contraction was 65 +/- 66 min in group A, 375 +/- 336 min in group B, 70 +/- 64 min in group C and 58 +/- 53 min in group D, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Intravaginal↗
PubMed2003

Out-patient antibiotics switch therapy in pediatric urinary tract infection.

OBJECTIVE: To compare the outcomes of out-patient antibiotics switch therapy with the treatment provided in the hospital among pediatric urinary tract infection (UTI) cases. MATERIAL AND METHOD: A comparative study was carried out using the febrile UTI patients of age 1 month-15 years in the observation room (OPD), Queen Sirikit National Institute of Child Health, Bangkok, Thailand, from 1st January 2000 to 31st December 2000 and the admitted pediatric UTI cases during the same period. The treatment at the OPD was started with parenteral antibiotics, then switched to oral form when the patients were clinically improved and defervesence occurred. RESULTS: There were 95 cases of pediatric UTI of which 29 cases were treated in the observation room as out-patient, 66 cases were treated as in patients after admitting them. The success rate of treatment was the same in both groups. The patients in the observation room were fit enough to be discharged but continued oral treatment within 1.93 +/- 0.65 days, compared with 6.24 +/- 2.72 days of the admitted group. Gentamicin and ceftriazone were the two most common parenteral antibiotics and norfloxacin was the most commonly prescribed oral antibiotics in both group. Mean age of the OPD group (6.24 +/- 2.72 years) was higher than the admitted group (0.97 +/- 1.7 year). Escherichia coli (E. coli) was the most commonly found organism in the urine culture and the sensitivity pattern was the same in both groups. CONCLUSION: The study revealed that some pediatric UTI patients can be treated as out-patients using antibiotics switch therapy in the observation room instead of being admitted.

Adolescent↗
PubMed2003

[Comparative studies on activities of antimicrobial agents against causative organisms isolated from patients with urinary tract infections (2001). III. Secular changes in susceptibility].

The bacteria (Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Klebsiella spp. and Pseudomonas aeruginosa) isolated from patients diagnosed as urinary tract infections (UTIs) in 10 institutions in Japan were supplied between September and December, 2001. Then, the susceptibilities of these bacteria to various antimicrobial agents were examined, and the results were compared with those obtained between 1992 and 2000. Comparison was made by classifying strains isolated from patients into those in uncomplicated UTIs and those in complicated UTIs (including with or without indwelling catheter). The drug sensitivity of S. aureus in this year was comparable to those in up to the previous year, and S. aureus showed the best susceptibility to vancomycin (VCM). E. faecalis showed good susceptibility to ampicillin and imipenem, and the MIC90s were 2 micrograms/mL. The susceptibility of E. faecalis to VCM was also good. E. coli showed good susceptibility to the drugs except penicillins. Among cephems, the susceptibility to cefozopran (CZOP) was better (MIC90: < or = 0.125 microgram/mL). Just as the last report, the decreases in susceptibility of E. coli to quinolones were also observed in the patients with complicated UTIs. The susceptibility of Klebsiella spp. to all the test drugs did not significantly change in 2001 and was generally good but not to penicillins. Among cephems, Klebsiella spp. showed good susceptibility to flomoxef, cefpirome, cefixime, and CZOP with < or = 0.125 microgram/mL of MIC90s either in uncomplicated or complicated UTIs. Although the drug sensitivity of P. aeruginosa was generally low, the detection of the strains that showed good susceptibility to quinolones and carbapenems (MIC: < or = 0.125-2 micrograms/mL) were relatively frequent.

Anti-Bacterial Agents↗
PubMed1992

[Urinary trypsin inhibitor as an acute phase reactant].

Early in this century, trypsin inhibiting activity has already been recognized in patients with acute infection or renal disease. In addition to these, conditions such as coronary thrombosis, surgical operation, artificial fever by heat-killed bacilli, malignancy, leukemia, later stage of normal pregnancy, etc. have been known to cause the elevated excretion of UTI in urine. Typically, maximal excretion of UTI has been observed within one or two days after the onset. It appears that recent studies have overcome the complexity of UTI molecule. Automated measurement of urinary trypsin inhibitor (UTI) in urine sample was carried out by either enzymic or immunologic method. UTI as well as erythrocyte sedimentation rate and C-reactive protein enables us to monitor acute phase response, being confirmed in cases of abdominal surgery.

Abdomen↗
PubMed2004

[Effect of urinary tract infections in children with chronic renal failure on peritoneal dialysis].

UNLABELLED: Urinary tract infections (UTI) in children on dialysis treatment are regarded as indirect contraindication for kidney transplantation. In medication of UTI it is recommended to prescribe antibacterial agent in proper dosage (often in reduced amount) and to choose desired drug in selected period of chronic renal failure (CRF). THE AIM: of the study was the evaluation of UTI incidence in children and adolescents with terminal renal failure on peritoneal dialysis treatment (PD), kind of isolated bacterial strains and their current drug-sensitivity. MATERIALS AND METHODS: The study included 26 children and young adults (15 girls and 11 boys) on PD for the period longer than 6 months (mean 2.0+/-1.5 years). The mean age of examined children was 13.2+/-4.4 years. Total number of 57 culture-positive UTI episodes were recorded (30 in girls, 27 in boys)--1-episode/11.1 patient-month. In examined group UTI most frequently were present in children with uncorrected urinary tract malformation (1 episode/7.7 patient-month) and in children on immunosuppressive treatment (1 episode/5.7 patient-month). In children with cystic kidney disease infections had accidental character. CONCLUSIONS: The most frequent occurring pathogen was bacteria Escherichia coli--13 (22.8%) and Streptococcus faecalis--13 (22.8%) infections. E. coli strains shown sensitivity to second generation of quinolones: ciprofloxacin; third generation of cephalosporin: ceftazidime; partial sensitivity to amoxicillin with clavulanic acid, aminoglycosides. Streptococcus faecalis strains revealed only partial sensitivity to nitrofurantoin, vancomycin, teicoplanin.

Adolescent↗
PubMed2004

Urinary tract infection--2003.

Urinary tract infections (UTI) are one of the most common and most intensively studied infections encountered in clinical practice. It is, however, an area where significant confusion has existed in agreeing the criteria for diagnosis, the natural history of disease, and the treatment. In the present paper etiology and risk factors for uncomplicated UTI, treatment of UTI, estrogen in UTI treatment in postmenopausal women and UTI in patients with diabetes and renal insufficiency were discussed.

Anti-Bacterial Agents↗
PubMed2004

Evaluation of extended spectrum beta lactamase in urinary isolates.

BACKGROUND & OBJECTIVES: Urinary tract infection (UTI) remain the common infections diagnosed in outpatients as well as in hospitalized patients. Current knowledge on antimicrobial susceptibility pattern of uropathogens is mandatory for appropriate therapy. Extended spectrum beta lactamases (ESBL) hydrolyse expanded spectrum cephalosporins like ceftazidime, cephotaxime which are used in the treatment of UTI. ESBL producing bacteria may not be detectable by routine disk diffusion susceptibility test, leading to inappropriate use of antibiotics and treatment failure. Not much information on ESBL producing organisms causing UTI is available from India. An effort was therefore made to study the ESBL producing uropathogens and also the susceptibility patterns of ESBL and nonESBL producers. METHODS: Urinary isolates from symptomatic UTI cases attending or admitted to the Indira Gandhi Medical College and Hospital, Nagpur were identified by conventional methods. Antimicrobial susceptibility testing was done by Kirbey Bauer's disc diffusion method. Isolates resistant to cephotaxime were tested for ESBL production by double disc synergy test method. RESULTS: Of the 217 isolates, 87 were cephotaxime resistant Gram-negative bacilli. Of these, 42 (48.3%) were found to be ESBL producers. Escherichia coli, Klebsiella pnuemoniae and Acinetobacter were ESBL producing species. Multidrug resistance was found to be significantly (P<0.05) more in ESBL producing isolates (90.5%) than non ESBL producers (68.9%). INTERPRETATION & CONCLUSION: In the present study a large number of uropathogens were found to be ESBL producers. Most of the ESBL producing isolates were multidrug resistant. Monitoring of ESBL production and antimicrobial susceptibility testing are necessary to avoid treatment failure in patients with UTI.

Drug Resistance, Multiple, Bacterial↗
PubMed2004

[Imipenem and cefepime in empirical therapy of infectious complications after radical surgeries in patients with invasive cancer of the urinary bladder].

Urinary tract injection (UTI) is one of the main causes of severe complications and death in oncologic patients and particularly in patients with invasive cancer of the urinary bladder. In our Clinic an up-to-date system for infection control recording all cases of UTI in oncologic patients is being exploited since 2001. The paper presents the data on our observations during the period from 2001 to 2003 concerning typical UTI in patients with invasive cancer of the urinary bladder, etiological agents of UTI and their susceptibility to a wide range of antibacterials, including imipenem and cefepime, a 4th generation cephalosporin, used for adequate therapy of UTI in oncourologic patients.

Adult↗
PubMedDate not supplied

[Guidelines for antimicrobial treatment and prophylaxis of urinary tract infections].

Recommendations for antimicrobial treatment and prophylaxis of urinary tract infections (UTI) have been made according to the results of investigation of resistance of the most frequent causative agents of UTI to antimicrobial drugs. This investigation has been conducted for the past seven years by the Committee for monitoring bacterial resistance to antibiotics in the Republic of Croatia, with consensus of eight professional societies of the Croatian Medical Association. Uncomplicated cystitis is treated 1, 3, or 7 days, complicated 7 days, pyelonephritis 10-14 days, and complicated UTI 7 to 14 days, rarely longer. For the treatment of cystitis fluorokinolons, nitrofurantoin, betalactam antibiotics, and in the fields of lower resistance trimethoprim/sulfamethoxazol are being used. Single treatment with fluorokinolons is administered to otherwise healthy young women with normal urinary tract in whom cystitis symptoms have been present for less than 7 days. Empiric antimicrobial treatment of pyelonephritis, recurrent and all complicated UTI must be reviewed after urine culture finding is obtained. In the treatment of bacterial prostatitis and febrile UTI in males, the drug of first choice is ciprofloxacin. Asymptomatic bacteriuria (AB) is treated in pregnant women, newborns, preschool children with urinary tract abnormalities, before invasive urologic and gynecologic procedures, in kidney transplant recipients, and in the first days of short term urinary bladder catheterization. Recommendations for the treatment of AB in patients with diabetes mellitus have been controversial in the past two years. Antimicrobial prophylaxis is administered mostly one hour prior to the diagnostic or therapeutic invasive urological procedure, using selected antimicrobial agents.

Anti-Bacterial Agents↗
PubMed2004

[Effect of ulinastatin on human blood coagulation and platelet aggregation in orthopaedic surgery].

OBJECTIVE: To investigate the effect of ulinastatin (UTI) on human blood coagulation and platelet aggregation in orthopaedic surgery. METHODS: Thirty ASA I-II patients without blood dyscrasia and blood coagulation obstacle were randomly divided into two groups: Group I (UTI group, n=15) in which patients received UTI 5000 U/kg, and Group II (control group, n=15) in which patients received NS 100 ml. PT, TT, APTT, IB, INR and PAG1, PAG5, and PAGM were measured at 3 points: pre-infusion (T0), 1 hour after the infusion (T1), and 2 hours after the infusion (T2). RESULTS: Compared with the saline group, APTT and PT of UTI group were prolonged significantly than the baseline (before infusion). In Group I, after the infusion, APT, TT and PT were prolonged significantly than before the infusion. CONCLUSION: UTI 5000 U/kg can ameliorate orthopaedic patients and blood coagulation status,which may reduce microthrombus syndrome in the operation and prevent venous thrombosis after the operation.

Adult↗
PubMed2005

[Effects of ulinastatin on cerebral inflammatory response during cardiopulmonary bypass].

OBJECTIVE: To investigate the effects of ulinastatin (UTI) on cerebral inflammatory response during cardiopulmonary bypass (CPB). METHODS: Twenty-four NYHA II-III patients (13 males and 11 females) aged 23-45 years, undergoing elective cardiac valve replacement under hypothermic CPB were randomly divided into 2 groups: ulinastatin group (Group U, n=12) and control group (Group C, n=12). In group U, UTI (1.2 x 10(4) U/kg) was given intravenously after the induction of anesthesia, 0.6 x 10(4) U/kg UTI was added to the priming solution, and 0.6 x 10(4) U/kg UTI was given about 5 min before the aortic decamping. In Group C, normal saline was given instead of UTI. Internal jugular vein was cannulated and the catheter was advanced retrogradely till jugular bulb. Blood samples were taken simultaneously from artery and jugular bulb after induction of anesthesia (T1), 60 min (T2) and 6 h (T3) after discontinuation of CPB for determination of TNFalpha, IL-6, IL-8 and IL-10. The juguloarterial gradients of these cytokines (deltaTNFalpha, deltaIL-6, deltaIL-8, and deltaIL-10) were calculated. RESULTS: In Group C, arterial levels of TNFalpha, IL-6, IL-8, IL-10 at T2 and T3, deltaTNFalpha, deltaIL-8 and deltaIL-10 at T2, deltaTNFalpha, deltaIL-6 and deltaIL-10 at T3 significantly increased (P < 0.01). deltaIL-8 increased at T3 (P < 0.05). In Group U, arterial levels of IL-6, IL-8, IL-10 at T2, arterial levels of IL-6, IL-8,IL-L-10 and deltaTNFalpha, deltaIL-8 at T3 significantly increased (P < 0.01). Arterial levels of TNFalpha at T2 and T3, deltaTNFalpha, deltaIL-10 at T2, deltaIL-6 at T3 increased (P < 0.05). Arterial levels of TNFalpha, IL-6 and deltaTNFalpha, deltaIL-8 at T2, arterial levels of TNFalpha and deltaIL-6 at T3 in Group U were lower than those in Group C (P < 0.05). Arterial levels of IL-6 at T3, IL-8 at T2 and T3 in Group U were significantly lower than those in Group C (P < 0.01). Arterial levels of IL-10 and deltaIL-10 at T3 in Group U were higher than those in Group C (P < 0.05). CONCLUSION: Systemic and cerebral activation of inflammatory response during CPB can be alleviated by ulinastatin.

Adult↗
PubMed2006

[Non-antibiotic prophylaxis for recurrent urinary-tract infections].

Urinary-tract infections (UTIs) occur frequently and hence have significant financial implications. Antibiotic prophylaxis can be considered in women with recurrent UTIs. However, frequent exposure to antibiotics can lead to antimicrobial resistance and side effects. The most important steps in the pathogenesis of UTIs are the colonisation and adherence of uropathogens. Lactobacilli impede intravaginal colonisation by competing with uropathogens. Cranberries interfere with the adherence of uropathogens to uroepithelial cells. Therefore, cranberries and lactobacilli are potential alternatives in the prophylaxis of UTIs. Randomised clinical trials comparing these compounds with long-term, low-dose antibiotics for the prevention of recurrent UTIs in women have not yet been conducted. Such a trial has recently been started in The Netherlands: the 'Non-antibiotic versus antibiotic prophylaxis for recurrent urinary-tract infections' (NAPRUTI) study.

Female↗
PubMed2006

Frequency and susceptibility profile of pathogens causing urinary tract infections at a tertiary care hospital in western Nepal.

INTRODUCTION: Urinary tract infection (UTI) is the most common nosocomial infection among hospitalised patients. Area-specific monitoring studies aimed to gain knowledge about the type of pathogens responsible for UTIs and their resistance patterns may help the clinician to choose the correct empirical treatment. Recent reports have shown increasing resistance to commonly-used antibiotics. We aimed to study the antibiotic resistance pattern of the urinary pathogens isolated from hospitalised patients. METHODS: Three urine samples were collected by the mid-stream "clean catch" method from 1,680 clinically-suspected cases of urinary tract infections from inpatients of various clinical departments during one year. The samples were tested microbiologically by standard procedures. Antibiotic susceptibility of the isolated pathogens was tested for commonly-used antibiotics by Kirby-Bauer technique according to NCCLS guidelines. RESULTS: Significant bacteriuria was present in 71.7 percent of the samples, 17 percent were sterile, 4.8 percent showed insignificant bacteriuria, and 6.5 percent non-pathogenic bacteriuria. The most common pathogens isolated were Escherichia coli (59.4 percent), Klebsiella spp (15.7 percent) and Enterococcus faecalis (8.1 percent). The mean susceptibility was high for amikacin (87.2 percent), ciprofloxacin (74.8 percent), ceftazidime (71.5 percent) and gentamicin (70.4 percent) but low for nitrofurantoin (35 percent), cephalexin (49.7 percent) and ampicillin (50.5 percent). Escherichia coli was found to be most susceptible to amikacin (98 percent) followed by gentamicin (87.9 percent), ceftazidime (80.8 percent), norfloxacin (78.4 percent) and cotrimoxazole (77.9 percent). CONCLUSION: A high isolation rate of pathogens from urine samples of clinically-suspected UTI shows a good correlation between clinical findings and microbiological methods. The antibiotics commonly used in UTIs are less effective. Since the present study was a cross-sectional study, regular monitoring is required to establish reliable information about resistance pattern of urinary pathogens for optimal empirical therapy of patients with nosocomial UTIs.

Adolescent↗
PubMedDate not supplied

Urinary tract infections in young infants with prolonged jaundice.

The incidence of urinary tract infections (UTIs) in young infants with jaundice is low, and prolonged jaundice in that setting is even rarer. In this study, we retrospectively reviewed the clinical features of 50 infants (seen from 1984 through 2004) 1 week to 3 months of age who had UTIs and prolonged jaundice and compared them with those of infants with UTIs in a similar age range at our hospital from a published study. The infants in our study had a lower incidence of high fever (12%), were less likely to have pyuria (29%), had fewer Escherichia coli but more Enterococcus species infections, and had more mixed infections (32%) than did the historical control. Klebsiella pneumoniae or Enterococcus species dominated in mixed infections (15/16) but the frequency of E. coli isolates did not differ significantly between mixed and single infections. We conclude that high fever and pyuria are unreliable criteria for screening for UTIs in young infants presenting with prolonged jaundice. Urine cultures should be obtained in such patients to determine whether a UTI is present. Mixed urinary infections, particularly K. pneumoniae and Enterococcus species, may play a key role in this entity.

Adult↗
PubMed1991

[Effect of intermittent catheterization on urinary tract infections and incontinence in children with spina bifida].

Although the primary objective of clean intermittent (self) catheterization (CIC) was to regain continence in (older) children with myelomeningocele (MMC), we used the method also in the very young with detrusor-sphincter dyssynergia, to prevent future damage from the combined effects of obstruction and urinary tract infection (UTI). The results, in terms of incidence of UTI and degree of incontinence before and during CIC, were assessed in 61 children with MMC who had started CIC between 1985 and 1988. Mean follow up was 45.3 +/- 27.3 months, mean age at the start of CIC was 6.9 +/- 4.6 years. The incidence of UTI during CIC proved significantly lower than before CIC (chi 2 = 20.92, p less than 0.001), and the improvement in incontinence was also statistically significant (chi 2 = 45.16, p less than 0.001). In children with MMC, CIC seems ideally suited to prevent damage to the kidneys from the life-long problem of recurrent UTI's. It will also help in preventing bladder wall fibrosis--an important cause of loss of detrusor compliance--secondary to repeated UTIs.

Adolescent↗
PubMed1991

[Importance of early diagnosis of urinary tract infections in childhood. Results of a retrospective study of children with vesico-uretero-renal reflux].

Urinary tract infections (UTI) in children are common. In the case of high grade vesico-ureteric-renal reflux (VUR) or urinary tract obstruction the abnormality may lead to end-stage renal failure. An early evaluation and adequate therapy after UTI are mandatory. Between 1980 and 1987 we evaluated 63 children with VUR. The symptoms of UTI are variable and age-dependent. Only in 13% of the children the urinary tract was evaluated after their first UTI. In 70% of the cases there were more than 1, mostly multiple UTI. The remaining 17% were admitted for other reasons. The relation boys to girls was 1:2. In boys the diagnosis of VUR was made earlier than in girls: 57% of boys and 17% of girls in their first year of life. In 24% of the boys and in 36% of the girls VUR was found between the 5th and 15th year of life. In the case of high grade reflux (IV-V) the kidneys showed heavy damage, loss of function and hypertension at the time of diagnosis. The aim must be early diagnosis and adequate therapy to prevent avoidable damages.

Adolescent↗
PubMed1991

[Antimicrobial susceptibility of organisms infecting the urinary tract in northern Israel].

Urinary tract infections (UTI), especially in women, are very frequent and require antimicrobial treatment. The choice of drug depends on the susceptibility of the infecting organism. In many cases treatment is begun before the identity and susceptibility of the organism/s cultured are known. Knowledge of the profile of the infecting organisms and their drug susceptibility can improve the treatment of community-acquired UTI. We recorded the distribution and susceptibility of 50,699 positive UTI cultures, during the years 1986-7, in 2 community laboratories in northern Israel serving a population of about 830,000. The sensitivity of organisms to ampicillin was only 32 in the Haifa region and 42 in the Afula region and, respectively, to cotrimoxazole 51 and 76, to cephalexin 60 and 77, to nitrofurantoin 83 and 89, and to nalidixic acid 80 and 92. The differences between the regions were statistically significant. As a result of this study, we suggest that ampicillin should not be used empirically in UTI in these these 2 regions, nor cotrimoxazole in the Haifa region. All women with uncomplicated UTI should be treated with nitrofurantoin or nalidixic acid, provided they are not sensitive to these drugs and tolerate them well. The use of new drugs such as the quinolones and amoxicillin/clavulanic acid must be controlled and monitored to avoid rapid development of resistant strains.

Anti-Bacterial Agents↗