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Mecillinam resistan...
Mecillinam resistance and outcome of pivmecillinam treatment in uncomplicated lower urinary tract infection in women
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- Monsen, Tor J. (författare)
- Umeå universitet,Klinisk bakteriologi
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- Holm, Stig, 1933 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för biomedicin, avdelningen för mikrobiologi och immunologi,Institute of Biomedicine, Department of Microbiology and Immunology
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- Ferry, Björn Magnus (författare)
- Umeå universitet,Pedagogiska institutionen
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- Ferry, Sven A. (författare)
- Umeå universitet,Klinisk bakteriologi,Allmänmedicin
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(creator_code:org_t)
- 2013-07-30
- 2014
- Engelska.
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Ingår i: Apmis. - Hoboken : Wiley. - 0903-4641 .- 1600-0463. ; 122:4, s. 317-323
- Relaterad länk:
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- Pivmecillinam (PIV) is a first-line antimicrobial for treatment of lower urinary tract infection in women (LUTIW). Mecillinam, the active substance of PIV, is bactericidal mainly against gram-negative uropathogens, whereas gram-positive species are considered intrinsically resistant. However, successful treatment of LUTIW caused by Staphylococcus saprophyticus has been reported, but more rarely for other gram-positive species. The aim of this study was to compare clinical and bacteriological outcome of PIV vs placebo treatment among uropathogens with special focus on mecillinam-resistant isolates. We analysed data from a prospective, multicentre, placebo-controlled, primary health care, therapy study performed in Sweden in 1995-1998 that included 1143 women with symptoms suggestive of LUTIW. Urine cultures were collected and symptoms registered at inclusion and at follow-up visits. Overall, the efficacy of PIV was superior to that of placebo. Clinical and bacteriological outcomes of PIV treatment were similar for S. saprophyticus, Escherichia coli as for most other uropathogens irrespective of their susceptibility to mecillinam. However, the occurrence of enterococci increased nearly fivefold shortly post PIV treatment, although with mild symptoms and a high spontaneous eradication. As susceptibility to mecillinam in vitro did not predict bacteriological and clinical outcome of PIV treatment, we suggest that the present breakpoints for mecillinam should be revised.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Mikrobiologi inom det medicinska området (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Microbiology in the medical area (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Immunologi inom det medicinska området (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Immunology in the medical area (hsv//eng)
- SAMHÄLLSVETENSKAP -- Utbildningsvetenskap -- Pedagogik (hsv//swe)
- SOCIAL SCIENCES -- Educational Sciences -- Pedagogy (hsv//eng)
Nyckelord
- Cystitis
- mecillinam resistance
- pivmecillinam treatment
- uropathogens
- women
- ANTIBIOTIC-RESISTANCE
- NATURAL COURSE
- PRIMARY-CARE
- THERAPY
- PATHOGENS
- PROJECT
- Cystitis
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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