50 Years of Urinary Tract Infections and Treatments

Has Much Changed?

Brandon Lajiness; Michelle J. Lajiness


Urol Nurs. 2019;39(5):235-239. 

In This Article

Antimicrobial Stewardship

One significant change over the last 50 years has been limiting the use of antibiotics to "only when necessary" and with the right medication to prevent development of resistance (see Table 2). Bacterial resistance to antibiotics is spreading and poses a serious problem, and resistance is seen in uropathogens (Gupta et al., 2010). As a result, antibiotics should be administered rationally and their use properly restrained (Bartoletti et al., 2016).

E. coli has become highly resistant to many antibiotics over the last 5 decades. An article published in 1972 by Hulbert supported the use of oral penicillin G (PCN G) in the treatment of UTI; however, due to penicillin's previously wide-spread use, it is now considered ineffective for the treatment of UTI.

The IDSA recommends that local antimicrobial susceptibility patterns of E. coli should be considered in the selection of which empirical antimicrobial agent is used to treat the UTI. This information can be obtained through a local hospital clinical laboratory and is published annually. The reason is that if the antibiotic selected is highly resistant to local E. coli patterns, chances are, the current strain of E. coli will also be resistant. Bacteria can share antimicrobial resistance through the sharing of genetic information through bacterial plasmids, and there is also a possibility that if resistant bacteria are given, they may develop a stronger resistance to the drug. These factors, coupled with the fact the patient will not heal, makes the process of watching local E. coli patterns extremely necessary.