Title: Tips From Other Journals - American Family Physician
Headings: Managing Uncomplicated Urinary Tract Infections
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From Other Journals
Managing Uncomplicated Urinary Tract Infections
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Antibiotic Therapy for Urinary Tract Infections

Content: Jancel and Dudas review the prevention and treatment of uncomplicated cystitis. Uncomplicated infections are generally benign but, if not treated, can interfere with daily life. In healthy women, long-term adverse effects are rare. As many as 80 percent of infections are caused by Escherichia coli, and Staphylococcus saprophyticus accounts for another 5 to 15 percent. A small number of infections are caused by Enterococci, Klebsiella species and Proteus mirabilis. Antibiotics that are most useful to treat uncomplicated cystitis are well-tolerated, cover expected uropathogens, and have favorable pharmacokinetic profiles. The best tolerated cures use antibiotics, such as trimethoprim-sulfamethoxazole (TMP-SMX) or fluoroquinolones, that have little effect on vaginal and fecal bacterial flora. It is important for physicians to know local resistance patterns because most uncomplicated UTIs are treated empirically. Resistance to TMP-SMX, ampicillin, and first-generation cephalosporins has been increasing in some communities. In 1998, resistance to E. coli was twice as common in the western United States than in the Northeast.