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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 and The Israeli Urinary Tract Infection Group
Clinical Infectious Diseases
Vol. 34, No. 9 (May 1, 2002), pp. 1165-1169
Published by: Oxford University Press
Stable URL: http://www.jstor.org/stable/4483049
Page Count: 5
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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
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Abstract

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.

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