Cefaclor as a first-line treatment for acute uncomplicated cystitis: a retrospective single-center study

Autor: Junichiro Ishii, Yasukiyo Murakami, Dai Koguchi, Masaomi Ikeda, Masato Dobashi
Rok vydání: 2020
Předmět:
0301 basic medicine
Antibiotics
Cefazolin
Levofloxacin
lcsh:RC870-923
Single Center
0302 clinical medicine
Drug Resistance
Multiple
Bacterial
Ampicillin
Cystitis
polycyclic compounds
Treatment Failure
030212 general & internal medicine
Cefaclor
Escherichia coli Infections
Aged
80 and over
General Medicine
Middle Aged
Staphylococcal Infections
Anti-Bacterial Agents
Treatment Outcome
Urinary Tract Infections
Female
Research Article
medicine.drug
Adult
medicine.medical_specialty
medicine.drug_class
Urology
030106 microbiology
Subgroup analysis
Microbial Sensitivity Tests
beta-Lactam Resistance
Young Adult
03 medical and health sciences
Fosfomycin
Internal medicine
Trimethoprim
Sulfamethoxazole Drug Combination
medicine
Humans
Amikacin
Acute uncomplicated cystitis
Aged
Retrospective Studies
High-power field
business.industry
lcsh:Diseases of the genitourinary system. Urology
Clinical efficacy
Klebsiella Infections
Reproductive Medicine
Proteus Infections
business
Zdroj: BMC Urology
BMC Urology, Vol 20, Iss 1, Pp 1-7 (2020)
ISSN: 1471-2490
DOI: 10.1186/s12894-020-00605-6
Popis: Background Wide-spectrum antibiotics have been favored to treat acute uncomplicated cystitis (AUC) for a long time, leading to the emergence of multi-drug resistant bacteria. We hypothesize that narrow-spectrum antibiotics might mitigate the issue and aim to investigate the clinical efficacy of cefaclor in patients with AUC. Methods We retrospectively reviewed the clinical data of female outpatients with AUC treated with cefaclor and evaluated the safety and clinical efficacy. Clinical cure was defined as the elimination of clinical symptom under 4 white blood cells (WBCs) per high power field on microscopy. Results Overall, 223 women with AUC were enrolled. Escherichia coli was the dominant pathogen (n = 160; 68.6%), followed by Klebsiella species and E. coli-extended spectrum β-lactamase (ESBL) (n = 19; 8.1% and n = 18; 7.7%). Overall success rate was 94.0% (n = 219) and susceptibility rate of cefazolin was 84.1%, which was close to that of levofloxacin (82.9%). Ampicillin showed the lowest rate of 63.7% with a significantly greater resistance rate of 35.3% among all antibiotics (P n = 24) or 93.3% (n = 14). The rate in patients with resistance to both antibiotics was 60.0% (n = 9), and the pathogens in the other 40.0% (n = 6) of patients with treatment failure were E. coli-ESBL. Conclusion Cefaclor showed excellent efficacy in AUC patients, even in those with in vitro resistance to cefazolin or levofloxacin. Cefaclor may be considered as a first-line option in patients with AUC and a second-line option for those with levofloxacin treatment failure.
Databáze: OpenAIRE
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