Journal article
The association of antimicrobial resistance with cure and quality of life among women with acute uncomplicated cystitis
Infection, Vol.39(6), pp.507-514
12/01/2011
DOI: 10.1007/s15010-011-0163-z
PMID: 21789523
Abstract
Background The association of in vitro resistance with bacteriologic, clinical, and health-related quality of life (HRQoL) outcomes for acute uncomplicated cystitis is unclear.
Methods We conducted a prospective study of women aged 18-40 years with acute uncomplicated cystitis symptoms for <= 7 days who subsequently grew an Enterobacteriaceae sp. and initially received trimethoprim/sulfamethoxazole (TMP/SMX) and phenazopyridine. We conducted telephone follow-up evaluating clinical cure at 1-3 days and in-person follow-up evaluating clinical, bacteriologic, and HRQoL outcomes at 3-7 days and 4-6 weeks post-treatment.
Results An Enterobacteriaceae sp. was isolated in 139 (96.5%) patients (25.2% TMP/SMX-resistant). At 1-3 days post-treatment, clinical cure occurred in 56/81 (69.1%) and 14/31 (45.2%) of cases with susceptible and resistant strains, respectively (difference 23.9%; 95% confidence interval [CI], 1.5-46.4%). At 3-7 days post-treatment, bacteriologic cure occurred in 70/73 (95.9%) and 15/25 (60%) of cases with susceptible and resistant strains, respectively (difference 35.9%; 95% CI, 13.5-58.3%). Sustained clinical cure rates at 3-7 days and 4-6 weeks post-treatment were 65.4 and 56.8% with susceptible strains, and 45.2 and 45.2% with resistant strains, respectively. The HRQoL scale assessing role limitations due to physical health problems was lower in TMP/SMX-resistant versus TMP/SMX-susceptible infections, with twice as many hours of missed activities reported (mean, 18.4 vs. 9.1 h). Differences in HRQoL appeared to be largely related to differences in clinical cure rates.
Conclusions Among women treated for acute uncomplicated cystitis with TMP/SMX, in vitro TMP/SMX resistance was associated with lower bacteriologic and clinical cure rates, and had greater impact on the time lost from daily activities compared to those with TMP/SMX-susceptible infections.
Details
- Title: Subtitle
- The association of antimicrobial resistance with cure and quality of life among women with acute uncomplicated cystitis
- Creators
- F. M. Abrahamian - Olive View-UCLA Medical CenterA. Krishnadasan - University of California, Los AngelesW. R. Mower - University of California, Los AngelesG. J. Moran - Olive View-UCLA Medical CenterJ. R. Coker - Division of Emergency Medicine, Department of Medicine, Olive View-University of California Los Angeles (UCLA) Medical Center, Sylmar, USAD. A. Talan - Olive View-UCLA Medical Center
- Resource Type
- Journal article
- Publication Details
- Infection, Vol.39(6), pp.507-514
- Publisher
- Springer Nature
- DOI
- 10.1007/s15010-011-0163-z
- PMID
- 21789523
- ISSN
- 0300-8126
- eISSN
- 1439-0973
- Number of pages
- 8
- Grant note
- Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; United States Department of Health & Human Services; Centers for Disease Control & Prevention - USA AspenBio Pharma, Inc. Aggenix, Inc. Education and Research Institute at Olive View-UCLA Medical Center, Sylmar, California Ortho-McNeil
- Language
- English
- Date published
- 12/01/2011
- Academic Unit
- Emergency Medicine; Internal Medicine
- Record Identifier
- 9984297148402771
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