The Percentage of Antibiotic Resistance in Uncomplicated Community-Acquired Urinary Tract Infections-Findings of the RedAres Project
Abstract
BACKGROUND
Uncomplicated bacterial urinary tract infections (uUTIs) are commonly seen in outpatient practice. They are usually treated empirically with antibiotics. The pertinent German Clinical Practice Guideline contains recommendations on antibiotic selection, with the additional advice that the local resistance situation should be considered as well. However, up-to-date information on local resistance is often unavailable, because microbiological testing is mainly recommended for complicated UTIs. Resistance rates are often higher in recurrent uUTIs than in single episodes. In this study, we aimed to determine the resistance rates of Escherichia coli (E. coli) in patients with community-acquired uUTIs and to make these data available to the treating physicians.
METHODS
In a nationwide cross-sectional study in Germany (DRKS 00019059), we determined the percentages of resistance to antibiotics recommended for uUTIs (first choice: fosfomycin, nitroxoline, mecillinam, nitrofurantoin, trimethoprim; second choice: cefpodoxime, ciprofloxacin, cotrimoxazole, levofloxacin, norfloxacin, ofloxacin) over the period 2019-2021. The data were stratified by single episodes vs. recurrent UTIs (rUTIs).
RESULTS
Data from 2390 subjects were analyzed. E. coli was found in 75.4% of the samples with positive urine cultures (1082 out of 1435). The resistance rate of E. coli in single episodes (n = 725) was less than 15% for all antibiotics tested. In rUTIs (n = 357), resistance rates were also…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 2,390 participants or records.
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