Uncomplicated lower urinary tract infections in females--clinical aspects, aetiology and antimicrobial resistance epidemiology. Results of the ARESC (Antimicrobial Resistance Epidemiological Survey on Cystitis) study in Poland and their implications for empiric therapy
Abstract
UNLABELLED: The Polish results of the international ARESC study are reported concerning clinical aspects, epidemiology, and antimicrobial susceptibility of uropathogens.
METHODS: Patients between 18 and 65 years with symptoms of uncomplicated cystitis were consecutively enrolled and investigated clinically including urinalysis and urine culture. Uropathogens were identified and their susceptibility was tested for nine antimicrobials
RESULTS: In Poland a total of 212 patients were enrolled and 119 uropathogens from 118 patients were identified. Escherichia coli was the most frequent (90; 75.6%), followed by Staphylococcus saprophyticus (5; 4.2%), Staphylococcus aureus (4; 3.4%), Proteus mirabilis (4; 3.4%), Klebsiella pneumoniae (3; 2.5%), E. coli showed the highest rate of susceptibility to fosfomycin (98.9%) followed by mecillinam (97.8%), nitrofurantoin (92.2%), and ciprofloxacin (92.2%). The lowest rate was found for ampicillin (40.0%) followed by cotrimoxazole (80.0%). For the total spectrum the order was fosfomycin (97.1%), ciprofloxacin (93.1%), and nitrofurantoin (85.2%). The lowest rates were found again for ampicillin (43.2%) and cotrimoxazole (80.7%).
CONCLUSIONS: The results indicate that fosfomycin, ciprofloxacin, nitrofurantoin and amoxicillin/clavulanate have preserved their good in vitro activity (> 80%) against both E. coli and the total spectrum of uropathogens.
How strong is the evidence?
Evidence Hub reads this as a clinical trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 212 participants or records.
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