Cefixime-clavulanic acid in ESBL-producing E. coli lower urinary tract infections: a 13-patient case series
Abstract
Background: Urinary tract infections (UTIs) represent a substantial proportion of community-acquired infections. The increasing prevalence of Escherichia coli strains that produce extended spectrum beta-lactamases (ESBL) poses a significant obstacle to effective infection treatment. Although carbapenems remain highly effective against ESBL-producing isolates, their use in lower UTIs is limited by the need for intravenous or intramuscular administration, hospitalization, high cost, and the risk of collateral damage due to their broad-spectrum activity. Therefore, there is a growing need for effective oral alternatives.
Methods: This retrospective study evaluated the clinical and microbiological outcomes of 13 patients diagnosed with lower UTIs caused by ESBL-producing E. coli (ESBL-PE), treated with oral cefixime-clavulanic acid (400/125 mg every 12 hours for 14 days). Follow-up urine cultures were obtained on days 3-5 and/or at the end of treatment (days 11-14).
Results: On days 3-5 of treatment, microbiological and clinical success rates were 53.8% (7/13) and 61.5% (8/13) respectively. At the end of the treatment, urine culture results could be evaluated in 10 cases, microbiological success was 80% (8/10). Clinical success was 84.6% (11/13). Re-infection and relapse rates on day 30 post-treatment were 7.7% (1/13) and 30.8% (4/13), respectively.
Conclusions: Cefixime-clavulanic acid may be considered an alternative to older antibiotics such as fosfomycin and nitrofurantoin…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 13 participants or records.
Read the paper
Related studies
- Association of lower urinary tract symptoms and OAB severity with quality of life and mental health in China, Taiwan and South Korea: results from a cross-sectional, population-based study
- Ten-Day Quadruple Therapy Comprising Low-Dose Rabeprazole, Bismuth, Amoxicillin, and Tetracycline Is an Effective and Safe First-Line Treatment for Helicobacter pylori Infection in a Population with High Antibiotic Resistance: a Prospective, Multicenter, Randomized, Parallel-Controlled Clinical Trial in China
- The Role of the NLR and PLR in Urinary Tract Infection
- Threat of Antimicrobial Resistance among Pilgrims with Infectious Diseases during Hajj: Lessons Learnt from COVID-19 Pandemic
- Leclercia adecarboxylata urinary tract infection in a patient with bladder cancer and recurrent hematuria
- A Case Series of Staphylococcus lugdunensis Infection in Cancer Patients at an Academic Cancer Institute in the United States
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.