Single-dose amikacin plus 7 days of amoxicillin/clavulanate to treat acute cystitis caused by extended-spectrum beta-lactamase-producing Escherichia coli: A retrospective cohort study
- Authors
- Ahn, Sun Tae; Han, Da Eun; Lee, Dong Hyun; Kim, Jong Wook; Park, Hong Seok; Moon, Du Geon; Oh, Mi Mi
- Issue Date
- 5월-2021
- Publisher
- KOREAN UROLOGICAL ASSOC
- Keywords
- Amikacin; Amoxi-clavulanate; Cystitis; Escherichia coli
- Citation
- INVESTIGATIVE AND CLINICAL UROLOGY, v.62, no.3, pp.310 - 316
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- INVESTIGATIVE AND CLINICAL UROLOGY
- Volume
- 62
- Number
- 3
- Start Page
- 310
- End Page
- 316
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/128150
- DOI
- 10.4111/icu.20200240
- ISSN
- 2466-0493
- Abstract
- Purpose: Treatment options for urinary tract infection (UTI) caused by extended-spectrum beta-lactamase (ESBL)-producing organisms are limited other than carbapenem. Accordingly, clinicians should investigate alternative antimicrobial options for limited infection. This study was performed to assess the efficacy of single-dose amikacin and a 7-day oral regimen of amoxicillin/clavulanate for the treatment of acute cystitis caused by ESBL-producing Escherichia coli and Klebsiella pneumoniae. Materials and Methods: A single-dose amikacin and 7-day oral amoxicillin/clavulanate regimen was given to all patients with acute cystitis or recurrent cystitis between May 2016 and October 2018. We conducted a retrospective cohort study assessing the efficacy of this regimen for the treatment of UTI due to ESBL-producing organisms. Both clinical and laboratory efficacy were assessed a minimum of 7 days and a maximum of 14 days after the completion of treatment. Results: A total of 47 patients were enrolled in this study. E. coli and K. pneumoniae were isolated in 44 patients (93.6%) and 3 patients (6.4%), respectively. Of the 47 enrolled, 39 patients (83.0%) showed sterile culture results on follow-up. Thirty-seven patients (78.7%) showed improvement of symptoms. Of 8 patients who showed bacterial persistence, 4 patients showed ESBL-producing E. coli, whereas 4 patients showed non-ESBL E. coli on follow-up cultures. During follow-up, 12 patients experienced the recurrence of acute cystitis with a median recurrence period of 2.5 months. Conclusions: The combination of amoxicillin/clavulanate and amikacin may be an alternative to carbapenem treatment in patients with acute cystitis caused by ESBL-producing Enterobacteriaceae.
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