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Logo of brjgenpracRCGP homepageJ R Coll Gen Pract at PubMed CentralBJGP at RCGPBJGP at RCGP
 
Br J Gen Pract. 2010 July 1; 60(576): 511–513.
PMCID: PMC2894379

Predictive value of antimicrobial susceptibility from previous urinary tract infection in the treatment of re-infection

Akke Vellinga, MSc, MEpid, Researcher
Discipline of General Practice, School of Medicine, NUI Galway, Ireland
Martin Cormican, MD, MRCP, FRCPath, Professor
Discipline of Bacteriology, School of Medicine, NUI Galway and consultant microbiologist, Galway University Hospitals, Galway, Ireland
Belinda Hanahoe, MSc, Surveillance Scientist
Department Medical Microbiology, University Hospital, Galway
Andrew W Murphy, MD, FRCGP, MICGP, Professor

Abstract

Recurrent urinary tract infections are often re-infections; therefore, antimicrobial susceptibility test results from a previous episode may guide the empiric therapy in subsequent episodes. This analysis provides predictive values of the antimicrobial susceptibility of previous Escherichia coli isolates for the treatment of re-infections in routine clinical practice. If resistance to ampicillin, trimethoprim, or ciprofloxacin is detected, re-prescription within 3 months is imprudent. Susceptibility to nitrofurantoin, ciprofloxacin, or trimethoprim in a previous sample supports their prescription for a re-infection within 3 months and up to a year. Resistance to nitrofurantoin is low and, once detected, decays relatively quickly. Nitrofurantoin should be considered as a first-line agent for initial and repeat treatment.

Keywords: antibiotic resistance, Escherichia coli, general practice, predictive value, urinary tract infection

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners