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Uncomplicated urinary tract infection (UTI) has become surprisingly complicated to treat in recent years because of growing prevalence of microbial resistance to trimethoprim-sulfamethoxazole (TMP-SMX) and quinolones. Many experts now propose resurrection of the venerable antibiotic nitrofurantoin as a first-line treatment for uncomplicated cystitis.
Mayo Clinic researchers constructed a decision tree to analyze the costs of common empirical antibiotic choices for uncomplicated UTI at different community levels of drug resistance. The model included costs of the drugs and of complications such as requisite retreatment, development of pyelonephritis, and development of vaginal candidiasis.
When 3-day courses of TMP-SMX or a fluoroquinolone wer…