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Because of high rates of Escherichia coli resistance to trimethoprim-sulfamethoxazole, fluoroquinolones commonly are prescribed as initial therapy for urinary tract infections (UTIs). However, rising rates of E. coli resistance to fluoroquinolones have engendered new concerns.
In a Denver public hospital system with several community health centers, researchers assessed antimicrobial prescribing trends and E. coli resistance patterns. Until 1999, trimethoprim-sulfamethoxazole was the recommended agent for UTI treatment within the health system; in 1999, system physicians were advised to switch to fluoroquinolones as initial therapy. A central laboratory database was used to identify all outpatients in whom E. coli was isolated from any speci…