In Vitro Activity of the Most Commonly Used Antibacterial Drugs Against Major Uropathogens
In 1999, the American Society of Infectious Diseases (IDSA) published recommendations in which cotrimoxazole was indicated as an initial treatment for uncomplicated acute bacterial cystitis in women if the resistance of pathogens to this drug in this region did not exceed not 10-20%.
The objective of this study, conducted by American scientists, was to find out whether the resistance level of the main uropathogens to cotrimoxazole has increased significantly in the United States recently. In addition to cotrimoxazole, other antibiotics have also been tested. Among 10,161 strains of uropathogens, resistance to cotrimoxazole was found in 17.4% of strains of Escherichia coli, 17.1% of strains of Proteus mirabilis, 10 , 5% Klebsiella pneumoniae and 2.9% - Staphylococcus saprophyticus. Multiple antibiotic resistances were found in 7.7% of P.mirabilis, 3% K. pneumoniae and 1.7% E.coli .
For example, current data on antibiotic resistance from the main infectious microorganisms in the urinary tract indicate that the efficacy of cotrimoxazole may be limited in certain regions of the United States.
Studies on the sensitivity of UTI pathogens in USA show that the prevalence of uropathogenic strains E. coli, resistant to ampicillin and cotrimoxazole, is very high and is respectively 33.3% and 18 , 4%. Modern fluoroquinolones (ciprofloxacin and norfloxacin) are the most active drugs compared to E. coli strains isolated from UTIs. Their resistance is 2.6%. In addition, ciprofloxacin and norfloxacin are active against Escherichia coli strains resistant to nalidixic acid and pipemidic acids. In general, the main problem is the resistance of uropathogens to ampicillin and cotrimoxazole.