Emerging resistance problems and future perspectives in pharmacotherapy for complicated urinary tract infections

Yen Hsu Chen, Wen-Chien Ko, Po Ren Hsueh

Research output: Contribution to journalReview article

24 Citations (Scopus)

Abstract

Introduction: Urinary tract infections (UTIs) are among the most common infectious diseases and contribute to high financial burden worldwide. Administration of appropriate antibiotic therapy is the key to achieving good therapeutic outcomes. The authors review the current status of global or regional epidemiology, especially on the antimicrobial resistance and several potential agents against complicated UTIs by multidrug-resistant (MDR) pathogens. Areas covered: The authors summarized the susceptibility status on several major surveillance programs on uropathogens, focusing on Enterobacteriaceae, Pseudomonas aeruginosa, Acinetobacter baumannii, methicillin-resistant Staphylococcus aureus, and vancomycin-resistant enterococci. Besides, the current perspectives of several potential antimicrobials against MDR uropathogens available for UTIs were also reviewed. Expert opinion: High resistance to broad-spectrum antibiotics, especially to extended-spectrum β-lactams, carbapenems, and fluoroquinolones among uropathogens emerges as a critical problem in many countries. Appropriate antimicrobial stewardship and continuous surveillance are necessary to monitor the trends of susceptibility for main pathogens. For these MDR uropathogens, polymyxin, fosfomycin, tigecycline, nitrofurantoin, linezolid, and daptomycin might be potential treatments for patients with uncomplicated and complicated UTIs in some countries, although they might not be approved by their regulation. However, more clinical evidence and more extensive meta-analyses are needed to evaluate and confirm the effectiveness of their usage in countries with a high prevalence of multidrug resistance.

Original languageEnglish
Pages (from-to)587-596
Number of pages10
JournalExpert Opinion on Pharmacotherapy
Volume14
Issue number5
DOIs
Publication statusPublished - 2013 Apr 1

Fingerprint

Urinary Tract Infections
Drug Therapy
Linezolid
Polymyxins
Daptomycin
Anti-Bacterial Agents
Fosfomycin
Nitrofurantoin
Acinetobacter baumannii
Lactams
Carbapenems
Fluoroquinolones
Expert Testimony
Multiple Drug Resistance
Enterobacteriaceae
Methicillin-Resistant Staphylococcus aureus
Pseudomonas aeruginosa
Communicable Diseases
Meta-Analysis
Epidemiology

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmacology (medical)

Cite this

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Emerging resistance problems and future perspectives in pharmacotherapy for complicated urinary tract infections. / Chen, Yen Hsu; Ko, Wen-Chien; Hsueh, Po Ren.

In: Expert Opinion on Pharmacotherapy, Vol. 14, No. 5, 01.04.2013, p. 587-596.

Research output: Contribution to journalReview article

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