The Medical Letter on Drugs and Therapeutics
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1395
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Drugs for Urinary Tract Infections

The most recent guidelines from the Infectious Diseases Society of America (IDSA) and its European counterpart on the choice of antimicrobials for treatment of uncomplicated urinary tract infections (UTIs) in non-pregnant women focus on the unnecessary use of fluoroquinolones to treat uropathogens that are increasingly becoming resistant to them.1 Resistance of Escherichia coli to ciprofloxacin in the US has increased from 3% in 2000 to 17.1% in 2010.2

ACUTE UNCOMPLICATED CYSTITIS — Fluoroquinolones such as ciprofloxacin or levofloxacin should not be used as first-line agents for empiric treatment of uncomplicated cystitis. Before the infecting organism is known, the drug of choice for non-pregnant women is trimethoprim/sulfamethoxazole (TMP/SMX) for 3 days, as long as the local rate of resistance to TMP/SMX among urinary pathogens ... more      

The Medical Letter is a subscriber-funded nonprofit organization that publishes critical appraisals of new prescription drugs and comparative reviews of drugs for common diseases.

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