Matching articles for "urinary tract infections"

Cefepime/Enmetazobactam (Exblifep) for Complicated Urinary Tract Infections

   
The Medical Letter on Drugs and Therapeutics • July 22, 2024;  (Issue 1707)
The FDA has approved Exblifep (Allecra), a fixed-dose combination of the cephalosporin cefepime and the beta-lactamase inhibitor enmetazobactam, for IV treatment of adults with complicated urinary...
The FDA has approved Exblifep (Allecra), a fixed-dose combination of the cephalosporin cefepime and the beta-lactamase inhibitor enmetazobactam, for IV treatment of adults with complicated urinary tract infections (cUTIs), including pyelonephritis, caused by designated susceptible microorganisms (see Spectrum of Activity). Exblifep is the first product that contains enmetazobactam to be approved in the US.
Med Lett Drugs Ther. 2024 Jul 22;66(1707):117-8 | Show Full IntroductionHide Full Introduction

Cefiderocol (Fetroja) - A New IV Cephalosporin for Complicated UTI

   
The Medical Letter on Drugs and Therapeutics • May 4, 2020;  (Issue 1597)
The FDA has approved cefiderocol (Fetroja – Shionogi), a new IV cephalosporin antibiotic, for treatment of complicated urinary tract infections (UTI) caused by susceptible gram-negative bacteria in adults...
The FDA has approved cefiderocol (Fetroja – Shionogi), a new IV cephalosporin antibiotic, for treatment of complicated urinary tract infections (UTI) caused by susceptible gram-negative bacteria in adults who have limited or no alternative treatment options.
Med Lett Drugs Ther. 2020 May 4;62(1597):65-8 | Show Full IntroductionHide Full Introduction

Plazomicin (Zemdri) - A New Aminoglycoside Antibiotic

   
The Medical Letter on Drugs and Therapeutics • November 5, 2018;  (Issue 1559)
The FDA has approved the new aminoglycoside antibiotic plazomicin (Zemdri – Achaogen) for IV treatment of adults with complicated urinary tract infections (cUTIs). Plazomicin is active against...
The FDA has approved the new aminoglycoside antibiotic plazomicin (Zemdri – Achaogen) for IV treatment of adults with complicated urinary tract infections (cUTIs). Plazomicin is active against multi-drug- resistant Enterobacteriaceae, including strains resistant to other aminoglycosides.
Med Lett Drugs Ther. 2018 Nov 5;60(1559):180-2 | Show Full IntroductionHide Full Introduction

In Brief: More Fluoroquinolone Warnings

   
The Medical Letter on Drugs and Therapeutics • August 13, 2018;  (Issue 1553)
The FDA has required changes in the labeling of all systemic fluoroquinolone antibiotics to strengthen warnings about the risk of severe hypoglycemia and mental health effects associated with their use.1An FDA...
The FDA has required changes in the labeling of all systemic fluoroquinolone antibiotics to strengthen warnings about the risk of severe hypoglycemia and mental health effects associated with their use.1

An FDA review identified 67 cases of hypoglycemic coma associated with fluoroquinolone use, 22 of which resulted in death or disability. Most cases occurred in patients with risk factors such as diabetes (especially those taking a sulfonylurea), older age, or renal insufficiency.1 In observational studies in older adults and patients with diabetes, fluoroquinolones have been associated with increased risks of hypo- and hyperglycemia.2,3 Patients taking a fluoroquinolone (especially those with risk factors) should be counseled about the symptoms of hypoglycemia and monitored for blood glucose disturbances. The drug should be stopped if dysglycemia occurs.

The labels of all systemic fluoroquinolones will now include warnings about delirium, agitation, nervousness, and disturbances in attention, memory, and orientation. These effects can occur after a single fluoroquinolone dose; the drug should be stopped if such effects occur. Systemic fluoroquinolones can also cause persistent or permanent peripheral neuropathy,4 and their use has been associated with an increased risk of pseudotumor cerebri syndrome.5

Other serious adverse effects associated with use of systemic fluoroquinolones include tendinitis and tendon rupture, exacerbation of myasthenia gravis, Clostridium difficile infection, and (except for delafloxacin [Baxdela]) QT-interval prolongation and torsades de pointes. The FDA recommends avoiding use of fluoroquinolones in patients with uncomplicated urinary tract infection, acute sinusitis, or acute exacerbation of chronic bronchitis, except when no alternative treatment option is available.6

Additional Content Available Online: Comparison Table: Some Systemic Fluoroquinolones

  1. FDA. July 10, 2018. Available at: www.fda.gov. Accessed August 2, 2018.
  2. LY Park-Wyllie et al. Outpatient gatifloxacin therapy and dysglycemia in older adults. N Engl J Med 2006; 354:1352.
  3. HW Chou et al. Risk of severe dysglycemia among diabetic patients receiving levofloxacin, ciprofloxacin, or moxifloxacin in Taiwan. Clin Infect Dis 2013; 57:971.
  4. In brief: Fluoroquinolones and peripheral neuropathy. Med Lett Drugs Ther 2013; 55:89.
  5. M Sodhi et al. Oral fluoroquinolones and risk of secondary pseudotumor cerebri syndrome: nested case-control study. Neurology 2017; 89:792.
  6. Alternatives to fluoroquinolones. Med Lett Drugs Ther 2016; 58:75.


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Med Lett Drugs Ther. 2018 Aug 13;60(1553):136 | Show Full IntroductionHide Full Introduction

Meropenem/Vaborbactam (Vabomere) for Complicated Urinary Tract Infection

   
The Medical Letter on Drugs and Therapeutics • June 18, 2018;  (Issue 1549)
The FDA has approved a fixed-dose combination of meropenem, a carbapenem antibiotic, and vaborbactam, a new beta-lactamase inhibitor (Vabomere – Melinta), for IV treatment of adults with complicated...
The FDA has approved a fixed-dose combination of meropenem, a carbapenem antibiotic, and vaborbactam, a new beta-lactamase inhibitor (Vabomere – Melinta), for IV treatment of adults with complicated urinary tract infections (UTIs) that are proven or strongly suspected to be caused by Escherichia coli, Klebsiella pneumoniae, or Enterobacter cloacae spp. complex. Meropenem (Merrem, and generics) has been approved for years for treatment of complicated skin and skin structure infections, intra-abdominal infections, and bacterial meningitis. Resistance to meropenem and other carbapenems, mainly due to production of carbapenemases and other extended-spectrum beta-lactamases (ESBLs), has been increasing worldwide, particularly among Enterobacteriaceae. Vabomere is the first carbapenem/beta-lactamase inhibitor combination to be marketed in the US.
Med Lett Drugs Ther. 2018 Jun 18;60(1549):103-5 | Show Full IntroductionHide Full Introduction

Drugs for Common Bacterial Infections in Adults

   
The Medical Letter on Drugs and Therapeutics • October 23, 2017;  (Issue 1532)
Bacterial infections in adults are generally treated empirically, with the antibiotic covering most, but not all, of the potential causative pathogens. For some infections, culture and sensitivity testing...
Bacterial infections in adults are generally treated empirically, with the antibiotic covering most, but not all, of the potential causative pathogens. For some infections, culture and sensitivity testing can guide treatment, allowing for use of narrower-spectrum antibiotics. The recommended dosages and durations of antibiotic treatment for common respiratory, skin, and urinary tract infections are listed in Tables 1-3. Infectious disease experts now recommend shorter treatment durations for many infections to reduce the development of antimicrobial resistance and minimize adverse effects.
Med Lett Drugs Ther. 2017 Oct 23;59(1532):171-7 | Show Full IntroductionHide Full Introduction

Alternatives to Fluoroquinolones

   
The Medical Letter on Drugs and Therapeutics • June 6, 2016;  (Issue 1496)
The FDA has announced that it is requiring changes in the labeling of systemic fluoroquinolones to warn that the risk of serious adverse effects, including tendinitis, peripheral neuropathy and CNS effects,...
The FDA has announced that it is requiring changes in the labeling of systemic fluoroquinolones to warn that the risk of serious adverse effects, including tendinitis, peripheral neuropathy and CNS effects, generally outweighs their benefit for the treatment of acute sinusitis, acute exacerbations of chronic bronchitis, and uncomplicated urinary tract infections. For these infections, the new labels will recommend reserving fluoroquinolones for patients with no other treatment options.
Med Lett Drugs Ther. 2016 Jun 6;58(1496):75-6 | Show Full IntroductionHide Full Introduction

Ceftazidime/Avibactam (Avycaz) - A New Intravenous Antibiotic

   
The Medical Letter on Drugs and Therapeutics • May 25, 2015;  (Issue 1469)
The FDA has approved ceftazidime/avibactam (Avycaz – Actavis) for IV treatment of complicated urinary tract and intra-abdominal infections in adults who have limited or no other treatment...
The FDA has approved ceftazidime/avibactam (Avycaz – Actavis) for IV treatment of complicated urinary tract and intra-abdominal infections in adults who have limited or no other treatment options. Ceftolozane/tazobactam (Zerbaxa – Cubist), another cephalosporin/beta-lactamase inhibitor combination, was approved in 2014.
Med Lett Drugs Ther. 2015 May 25;57(1469):79-80 | Show Full IntroductionHide Full Introduction

Ceftolozane/Tazobactam (Zerbaxa) - A New Intravenous Antibiotic

   
The Medical Letter on Drugs and Therapeutics • March 2, 2015;  (Issue 1463)
The FDA has approved ceftolozane/tazobactam (Zerbaxa – Cubist), a combination of a new cephalosporin antibiotic and a beta-lactamase inhibitor, for intravenous treatment of complicated urinary tract and...
The FDA has approved ceftolozane/tazobactam (Zerbaxa – Cubist), a combination of a new cephalosporin antibiotic and a beta-lactamase inhibitor, for intravenous treatment of complicated urinary tract and intra-abdominal infections in adults.
Med Lett Drugs Ther. 2015 Mar 2;57(1463):31-3 | Show Full IntroductionHide Full Introduction

Drugs for Bacterial Infections

   
The Medical Letter on Drugs and Therapeutics • July 1, 2013;  (Issue 131)
The text that follows reviews some common bacterial infections and their empiric treatment pending the results of culture and susceptibility testing. The recommendations made here are based on the results...
The text that follows reviews some common bacterial infections and their empiric treatment pending the results of culture and susceptibility testing. The recommendations made here are based on the results of susceptibility studies, clinical trials, and the opinions of Medical Letter reviewers. Tables 1 and 2 list the usual dosages of antibacterial drugs.
Treat Guidel Med Lett. 2013 Jul;11(131):65-74 | Show Full IntroductionHide Full Introduction

Addendum: Cost of Drugs for Acute Cystitis

   
The Medical Letter on Drugs and Therapeutics • August 20, 2012;  (Issue 1397)
A reader suggested that our July 23 article on Drugs for Urinary Tract Infection (Med Lett Drugs Ther 2012; 54:57)1 should have included information on the cost of the drugs we recommended for treatment of...
A reader suggested that our July 23 article on Drugs for Urinary Tract Infection (Med Lett Drugs Ther 2012; 54:57)1 should have included information on the cost of the drugs we recommended for treatment of acute uncomplicated cystitis.

Trimethoprim/sulfamethoxazole DS — Generic formulations are available at large discount pharmacies for $4 for 20 tablets. Trimethoprim/sulfamethoxazole DS is generally found on tier 1 (lowest co-pay) of insurance company formularies.

Nitrofurantoin monohydrate/macrocrystals — The wholesale acquisition cost of the generic formulation is about $2.50 per tablet (PricePointRx™).2 The drug is on tier 1 of some insurance company formularies, but on tier 2 or 3 of others.

Fosfomycin — Available only as Monurol, a single dose of fosfomycin is effective in most cases of acute uncomplicated cystitis, but the manufacturer charges a wholesale acquisition cost of more than $40 for that dose (PricePointRx™).2 Most insurance companies place Monurol on tier 3 of their formularies, or do not include it on their formularies at all.

Not recommended: Ciprofloxacin – Fluoroquinolones should not be used empirically to treat acute uncomplicated cystitis. The fact that ciprofloxacin is available at large discount pharmacies for $4 for 20 500-mg tablets and is on tier 1 on most insurance company formularies may be part of the reason for its continued overuse.

1. Drugs for urinary tract infection. Med Lett Drugs Ther 2012; 54:57.

2. PricePointRx™. Reprinted with permission by FDB. All rights reserved. ©2012. http://www.firstdatabank.com/support/drug-pricing-policy.aspx. Accessed July 31, 2012. Actual retail prices may be higher.

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Med Lett Drugs Ther. 2012 Aug 20;54(1397):67-8 | Show Full IntroductionHide Full Introduction

Drugs for Urinary Tract Infections

   
The Medical Letter on Drugs and Therapeutics • July 23, 2012;  (Issue 1395)
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)...
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. Resistance of Escherichia coli to ciprofloxacin in the US has increased from 3% in 2000 to 17.1% in 2010.
Med Lett Drugs Ther. 2012 Jul 23;54(1395):57-8 | Show Full IntroductionHide Full Introduction

Doripenem (Doribax) - A New Parenteral Carbapenem

   
The Medical Letter on Drugs and Therapeutics • January 28, 2008;  (Issue 1278)
Doripenem (Doribax - Ortho-McNeil Janssen), an intravenous (IV) carbapenem antibiotic with a spectrum of activity similar to that of imipenem and meropenem, has been approved by the FDA for treatment of...
Doripenem (Doribax - Ortho-McNeil Janssen), an intravenous (IV) carbapenem antibiotic with a spectrum of activity similar to that of imipenem and meropenem, has been approved by the FDA for treatment of complicated intra-abdominal and urinary tract infections. Use of doripenem for treatment of nosocomial pneumonia, including ventilator-associated pneumonia, is still under FDA review.
Med Lett Drugs Ther. 2008 Jan 28;50(1278):5-7 | Show Full IntroductionHide Full Introduction

Choice of Antibacterial Drugs

   
The Medical Letter on Drugs and Therapeutics • May 1, 2007;  (Issue 57)
Information about empirical treatment of bacterial infections, emerging trends in antimicrobial resistance, new drugs and new data about older drugs continue to become available. Usual pathogens and empiric...
Information about empirical treatment of bacterial infections, emerging trends in antimicrobial resistance, new drugs and new data about older drugs continue to become available. Usual pathogens and empiric treatment for some common types of infections are summarized in the text and a table listing the drugs of choice and alternatives for each pathogen begins on page 40. The recommendations made here are based on the results of susceptibility studies, clinical trials and the opinions of Medical Letter consultants.
Treat Guidel Med Lett. 2007 May;5(57):33-50 | Show Full IntroductionHide Full Introduction

Choice of Antibacterial Drugs

   
The Medical Letter on Drugs and Therapeutics • March 1, 2004;  (Issue 19)
New drugs for bacterial infections and new information about older drugs continue to become available. Empirical treatment of some common bacterial infections is discussed in this article. A table listing the...
New drugs for bacterial infections and new information about older drugs continue to become available. Empirical treatment of some common bacterial infections is discussed in this article. A table listing the drugs of choice and alternatives for each pathogen begins on page 18. These recommendations are based on results of susceptibility studies, clinical trials and the opinions of Medical Letter consultants. Local resistance patterns should be taken into account. Trade names are listed on page 24.
Treat Guidel Med Lett. 2004 Mar;2(19):13-22 | Show Full IntroductionHide Full Introduction

The Choice of Antibacterial Drugs

   
The Medical Letter on Drugs and Therapeutics • August 20, 2001;  (Issue 1111)
New drugs for treatment of bacterial infections and new information about older drugs continue to become available. Empirical treatment of some infections is discussed and a table listing the drugs of choice...
New drugs for treatment of bacterial infections and new information about older drugs continue to become available. Empirical treatment of some infections is discussed and a table listing the drugs of choice and alternatives for each pathogen are contained in this article. These recommendations are based on results of susceptibility studies, clinical trials and opinions of Medical Letter consultants. Local resistance patterns should be taken into account.
Med Lett Drugs Ther. 2001 Aug 20;43(1111):69-78 | Show Full IntroductionHide Full Introduction

Fosfomycin for Urinary Tract Infections

   
The Medical Letter on Drugs and Therapeutics • July 18, 1997;  (Issue 1005)
Fosfomycin, a broad-spectrum antibiotic used parenterally in Europe for many years, has been approved by the US Food and Drug Administration (FDA) as fosfomycin tromethamine (Monurol - Forest) for single-dose...
Fosfomycin, a broad-spectrum antibiotic used parenterally in Europe for many years, has been approved by the US Food and Drug Administration (FDA) as fosfomycin tromethamine (Monurol - Forest) for single-dose oral treatment of uncomplicated urinary tract infections in women.
Med Lett Drugs Ther. 1997 Jul 18;39(1005):66-8 | Show Full IntroductionHide Full Introduction

Cefpodoxime Proxetil - A New Oral Cephalosporin

   
The Medical Letter on Drugs and Therapeutics • November 27, 1992;  (Issue 884)
Cefpodoxime proxetil (Vantin - Upjohn), a new third-generation oral cephalosporin, has been approved for marketing by the US Food and Drug Administration. It is available for twice-daily treatment of...
Cefpodoxime proxetil (Vantin - Upjohn), a new third-generation oral cephalosporin, has been approved for marketing by the US Food and Drug Administration. It is available for twice-daily treatment of pharyngitis, upper and lower respiratory infections, otitis media, urinary tract infections, skin and soft tissue infections, and for single-dose treatment of uncomplicated gonorrhea in men or women and anorectal gonorrhea in women.
Med Lett Drugs Ther. 1992 Nov 27;34(884):107-8 | Show Full IntroductionHide Full Introduction

Enoxacin - A New Fluoroquinolone

   
The Medical Letter on Drugs and Therapeutics • November 13, 1992;  (Issue 883)
Enoxacin (en ox' a sin; Penetrex - Rh ne-Poulenc Rorer), a fluoroquinolone antimicrobial for oral use, has now been marketed in the USA for treatment of urinary tract infections and uncomplicated urethral or...
Enoxacin (en ox' a sin; Penetrex - Rh ne-Poulenc Rorer), a fluoroquinolone antimicrobial for oral use, has now been marketed in the USA for treatment of urinary tract infections and uncomplicated urethral or cervical gonorrhea.
Med Lett Drugs Ther. 1992 Nov 13;34(883):103-5 | Show Full IntroductionHide Full Introduction