Oral Amoxicillin-Clavulanic Acid Treatment in Urinary Tract Infections Caused by Extended-Spectrum Beta-Lactamase-Producing Organisms

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dc.authoridOTLU, BARIS/0000-0002-6220-0521
dc.authoridBeytur, Ali/0000-0002-7870-3318
dc.authorwosidYAKUPOGULLARI, YUSUF/F-3966-2011
dc.authorwosidOTLU, BARIS/ABI-5532-2020
dc.authorwosidBeytur, Ali/AAA-2823-2021
dc.contributor.authorBeytur, Ali
dc.contributor.authorYakupogullari, Yusuf
dc.contributor.authorOguz, Fatih
dc.contributor.authorOtlu, Baris
dc.contributor.authorKaysadu, Halim
dc.date.accessioned2024-08-04T20:44:02Z
dc.date.available2024-08-04T20:44:02Z
dc.date.issued2015
dc.departmentİnönü Üniversitesien_US
dc.description.abstractBackground: Extended-spectrum beta-lactamases (ESBLs) are increasing problems. The involvement of ESBL-producing organisms is associated with higher rates of carbapenem usage in urinary tract infections (UTIs). Though some strains are susceptible to amoxicillin-clavulanic acid (AMC) in vitro, there is very less data about the consequences of AMC usage for such infections. Objectives: The purpose of this study was to evaluate the clinical and microbiological outcomes of AMC treatment in UTIs caused by AMC-susceptible ESBL-producing organisms. Patients and Methods: A retrospective cohort study was conducted in a tertiary care hospital. Forty-six out of 652 patients (F/M ratio: 32/14; mean age: 43.9 years) with ESBL-positive UTIs were eligible for this study. These patients had cystitis (n = 23), vesicoureteral reflux (n = 7), hyperactive bladder (n = 6), and prostatitis (n = 10). Data was collected via chart review and was statistically analyzed. Results: AMC-susceptible ESBL-producing Escherichia coli, Klebsiella pneumoniae and K. oxytoca were identified as the causative agents in 31, 14, and 1 patients, respectively. Thirty-nine (84.7%) out of 46 patients were successfully treated with oral AMC. Additionally, 2 (4.3%) patients' urine cultures turned to be negative, though their clinical complaints and leukocyturia had continued. In the remaining 5 (10.8%) patients, no positive clinical and microbiological response was obtained. Increased minimum inhibitory concentration levels of AMC (from 4 to > 256 mu g/mL) were detected in these patients and the treatment failures were attributed to this developing resistance. We found that therapeutic failure was significantly more frequent in Klebsiella spp. than in E. coli (33.3% vs 6.5%, P = 0.029). Furthermore, no treatment failure was observed in pathogens with minimum inhibitory concentrations (MICs) <= 2 mg/mL, and the high AMC MIC (8 mg/mL) was associated with resistance development and therapeutic failure (71.4% vs. 5.1%, P = 0.0001). Conclusions: Our results suggested that amoxicillin-clavulanic acid may be a good oral antimicrobial which can be used for treatment of ESBL-positive UTIs, if the causative agent is susceptible to this antibiotic. However, some strains may develop resistance during therapy, especially in those exhibiting high AMC MICs.en_US
dc.description.sponsorshipInonu University [BAP: 2010-149]en_US
dc.description.sponsorshipThis study was financially supported by the Inonu University research fund (BAP: 2010-149).en_US
dc.identifier.doi10.5812/jjm.13792
dc.identifier.issn2008-3645
dc.identifier.issn2008-4161
dc.identifier.issue1en_US
dc.identifier.pmid25763134en_US
dc.identifier.scopus2-s2.0-85031294486en_US
dc.identifier.scopusqualityQ4en_US
dc.identifier.urihttps://doi.org/10.5812/jjm.13792
dc.identifier.urihttps://hdl.handle.net/11616/97991
dc.identifier.volume8en_US
dc.identifier.wosWOS:000352146200009en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherAhvaz Jundishapur Univ Med Scien_US
dc.relation.ispartofJundishapur Journal of Microbiologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectUrinary Tract Infectionen_US
dc.subjectBeta-Lactamaseen_US
dc.subjectAmoxicillin-Clavulanic Aciden_US
dc.titleOral Amoxicillin-Clavulanic Acid Treatment in Urinary Tract Infections Caused by Extended-Spectrum Beta-Lactamase-Producing Organismsen_US
dc.typeArticleen_US

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