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Review Article

IJMDC. 2021; 5(3): 968-973

Treatment of resistant urinary tract infection: a systematic review

Saleh Ahmed Alammari, Abdullah Radhyan A. AlRuwaili, Abdulaziz Abdullah Almutairi, Adeeb Naif Mhaileb Alshammari.


Background: Urinary tract infection (UTI) is frequent among both genders and in different age groups. However, the incidence of resistant infections is increasing, especially with the increased incidence of antimicrobial abuse. Furthermore, treatment options for these resistant infections are scarce, and their efficacy is controversial. This systematic review will demonstrate the management options and strategies for resistant UTI in different age groups among males and females over the last 10 years.
Method: The research team searched the medical literature via four databases, which were Medline, PubMed, Embase, and SCOPUS. The databases were searched with filters for English articles and publication dates between 2011 and 2021. The search keywords were “management” OR “treatment” AND “urinary tract infection” OR “UTI” AND “resistant” AND “antibiotics”. The next stage was revising the results to comprise original research studies that evaluated different regimens for the management of resistant UTIs. All the included studies mentioned the type of medication used for treatment and the type of resistant bacterial strain that caused the UTI.
Result: A total of 98 articles were retrieved. After filtering review articles and selecting original research studies solely, 12 articles were obtained. Eight research studies were eligible. Seven studies had a retrospective design. Fosfomycin was the most frequently tested antibiotic, as a monotherapy or in combination with either aminoglycoside or carbapenem. The most frequently identified strains were Escherichia coli and Klebsiella pneumoniae. Some studies also examined Pseudomonas aeruginosa and other Gram-negative bacilli.
Conclusion: Fosfomycin shows promising efficacy and safety profile against multidrug-resistant bacterial strains causing UTI. Further prospective studies on other antibiotic combinations are mandatory.

Key words: Urinary tract infection, resistant, bacteria, antibiotics.

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