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Study identifies risk factors for ciprofloxacin-resistant UTIs: recurrent UTI, fluoroquinolone use.(Gynecology)
CHICAGO -- Avoid empiric ciprofloxacin for uncomplicated urinary tract infections in patients with a history of recent exposure to fluoroquinolones or recurrent urinary tract infections, B. Joseph Guglielmo, Pharm.D., urged at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy.
His retrospective case-control study demonstrated that these patient characteristics constitute powerful risk factors that markedly increase the odds of infection by a ciprofloxacin-resistant isolate of Escherichia coli.
Such patients are best treated empirically with alternative agents. Among the drugs that are most reliably active against ciprofloxacin-resistant E. coli are the cephalosporins and nitrofurantoin, added Dr. Guglielmo of the University of California, San Francisco.
E. coli resistance to fluoroquinolones is an increasing problem, particularly in regions where trimethoprim / sulfamethoxazole (TMP/SMX) resistance is high. At the university, for example, more than 30% of urinary tract infections (UTIs) caused by E. coli are TMP/SMX-resistant, and 10% of all community acquired UTIs are ciprofloxacin-resistant.
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