The empirical choice of antibacterial treatment for uncomplicated urinary tract infection. “DARMIS”: clinical study of pathogens resistance

Perepanova T.S., Kozlov R.S., Dehnich A.V., Palagin I.S., Shevelev A.N., Volkova E.M., Egamberdiev D.K.

Objective: to improve the efficacy of treatment of acute lower urinary tract infection (LUTI) and increase of recurrent-free period in chronic infection of lower urinary tract by a rational antibacterial drug choice. Materials and methods. 987 strains of community-acquired uropathogens from 28 centers of 20 cities in Russian Federation. Belarus and Kazakhstan (903 from Russia) were collected.

Results: The share of Enterobacteriaceae family strains was 83.5%. E. coli was the pathogen of LUTI in 63.5% of patients, detection rates in patients with uncomplicated (64.6%) and complicated (62.1%) infections did not differ significantly. The most efficient agent against E. coli were fosfomicin (98.4%), furazidin (95.7%), nitrofurantoin (94.1%) and oral cephalosporins of 3rd generation (tesptibuten an cefixime). With respect to all Enterobacteriaceae family species the only oral medicine with more than 90% efficacy was fosfomicin (91.5%). Activity of furazidin and nitrofurantoin was 86.3% and 76.8% respectively. The most efficient agents of the parenteral drugs are carbapenems (ertapenem, meropenem, imipenem), strains resistant to that were not detected. Also high in vitro activity had Cefoperazone/ sulbactam (97.4%), piperacillin/ tazobactam (95.7%), cephalosporins of III-IV generation and amikacin (98.9%). With respect to all Enterobacteriaceae family species the most efficient were carbapenems. For empirical treatment of LUTI we recommend to prescribe drugs that are not used due to other indications.

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