Antibiotic-Resistant Urinary Tract Infections Treated in the Emergency Department: Attention Needed

Resistance to third-generation cephalosporins led to inappropriate therapy for common UTI pathogens, longer hospital stays, and higher mortality.

Community-acquired urinary tract infections (UTIs) caused by multidrug-resistant Gram-negative bacteria are increasingly common, often leading to inappropriate initial antimicrobial therapy. What are the consequences for infections caused by pathogens with third-generation cephalosporin resistance (3GCR) in patients presenting to the emergency department (ED)? Researchers performed a retrospective cohort study of 4107 adults admitted with febrile UTI caused by Escherichia coli, Klebsiella pneumoniae, or Proteus mirabilis (EKP) at 21 Kaiser Permanente EDs in Northern California. 3GCR cases (defined by EKP resistant to ceftriaxone, ceftazidime, or both) were compared with controls (non-3GCR EKP). Inappropriate initial antimicrobial therapy ad…

Reviewing Author

George Sakoulas, MD

Disclosures

Consultant/Advisory BoardParatek Pharmaceuticals; Nestle Corp.; AbbVie; Shionogi

Speaker’s BureauAllergan/AbbVie; Paratek Pharmaceuticals; Nestle Corp.

RoyaltiesUpToDate

Editorial BoardsAntimicrobial Agents and Chemotherapy; Open Forum Infectious Diseases

George Sakoulas, MD

Disclosures

Consultant/Advisory BoardParatek Pharmaceuticals; Nestle Corp.; AbbVie; Shionogi

Speaker’s BureauAllergan/AbbVie; Paratek Pharmaceuticals; Nestle Corp.

RoyaltiesUpToDate

Editorial BoardsAntimicrobial Agents and Chemotherapy; Open Forum Infectious Diseases

Antibiotic-Resistant Urinary Tract Infections Treated in the Emergency Department: Attention Needed

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Reviewing Author