Management of urinary tract infections in the era of increasing antimicrobial resistance.

Department of Medicine, University of Washington, 1959 Northeast Pacific Street, Box #356421, Seattle, WA 98195, USA. Amanda24@uw.edu

The Medical clinics of North America 2013 Jul

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Antimicrobial resistance of urinary pathogens is increasing. Most urinary tract infections (UTIs) should still be treated empirically. However, patients with recurrence or other risk factors for resistance may benefit from urine culture. Patients with recurrent UTI often resort to antibiotic prevention, a risky proposition in terms of resistance. Non-antimicrobial preventative methods should be considered first. If preventative antibiotics must be used, postcoital patient-initiated protocols are effective and reduce overall antibiotic exposure compared with continuous prophylaxis. Consider referring patients for urologic evaluation when at risk for complicated UTIs or when recurrence continues despite conservative interventions. Copyright © 2013 Elsevier Inc. All rights reserved.

Citation

Amanda Kay Shepherd, Paul S Pottinger. Management of urinary tract infections in the era of increasing antimicrobial resistance. The Medical clinics of North America. 2013 Jul;97(4):737-57, xii