Empiric Use of Trimethoprim-Sulfamethoxazole... : Clinical Infectious Diseases (original) (raw)

Empiric Use of Trimethoprim-Sulfamethoxazole (TMP-SMX) in the Treatment of Women with Uncomplicated Urinary Tract Infections, in a Geographical Area with a High Prevalence of TMP-SMX-Resistant Uropathogens

R. Raz
B. Chazan
Y. Kennes
R. Colodner
E. Rottensterich
M. Dan
I. Lavi
W. Stamm

Clinical Infectious Diseases

34(9):p 1165-1169, May 1, 2002.

| DOI: 10.1086/339812

This study evaluated whether trimethoprim-sulfamethoxazole (TMP-SMX) is effective for treatment of uncomplicated urinary tract infections (UTIs) due to TMP-SMX—resistant (TMP-SMX—R) pathogens. Healthy nonpregnant premenopausal women with symptomatic lower UTI were assessed for the presence of pyuria and bacteriuria; if either was present, a urine sample was cultured and TMP-SMX was prescribed. Clinical and microbiologic cure was assessed at days 5–9 and 28–42 after cessation of therapy. For 71%, of patients, cultures grew TMP-SMX—susceptible (TMP-SMX—S) microorganisms, and for 29%, cultures grew TMP-SMX—R organisms. Escherichia coli remained the predominant bacteria in both groups of cultures. At visit 2, microbiological cure had been achieved in 86% of the patients in the TMP-SMX—S group and 42% of those in the TMP-SMX—R group. Similar differences were found at visit 3 by clinical evaluation. Treatment with TMP-SMX of uncomplicated UTI caused by TMP-SMX—R microorganisms results in microbiologic and clinical failure. In high-resistance areas, TMP-SMX should not be the empiric drug of choice for uncomplicated UTI.