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Aminopenicillins for treatment of ampicillin-resistant enterococcal urinary tract infections. Am J Health Syst Pharm 2022 Jun 23;79(13):1056-1065

Date

03/18/2022

Pubmed ID

35299243

DOI

10.1093/ajhp/zxac068

Scopus ID

2-s2.0-85133100597

Abstract

PURPOSE: The purpose of this review is to describe the theory behind and data supporting use of aminopenicillins in the treatment of ampicillin-resistant enterococcal urinary tract infections.

SUMMARY: Aminopenicillin concentrations in the urine may be high enough to achieve bacterial eradication and clinical cure for infections affecting the lower genitourinary tract, even in the context of in vitro resistance based on established susceptibility breakpoints. A literature search was conducted to identify original research articles describing the use of aminopenicillins in the treatment of urinary tract infections caused by ampicillin-resistant Enterococcus species. Three published retrospective cohort studies were identified, all of which reported that aminopenicillins had similar rates of clinical cure as other antibiotic classes prescribed for the treatment of enterococcal urinary tract infections.

CONCLUSION: Both pharmacokinetic/pharmacodynamic principles and limited retrospective clinical data support the use of aminopenicillins in the treatment of lower urinary tract infections caused by Enterococcus species, even when the isolates have a minimum inhibitory concentration that exceeds the susceptibility breakpoint.

Author List

Bunnell K, Duong A, Ringsred T, Mian A, Bhathena S

Author

Kristen B. Bresnehan PharmD Assistant Professor in the School of Pharmacy Administration department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Ampicillin
Anti-Bacterial Agents
Enterococcus
Gram-Positive Bacterial Infections
Humans
Microbial Sensitivity Tests
Retrospective Studies
Urinary Tract Infections