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Revista Virtual de la Sociedad Paraguaya de Medicina Interna
On-line version ISSN 2312-3893
Abstract
MELGAREJO MARTINEZ, Laura Elizabeth et al. The treatment of uncomplicated acute cystitis of women in the community is a problem solved in the country?. Rev. virtual Soc. Parag. Med. Int. [online]. 2018, vol.5, n.1, pp.59-70. Epub Mar 01, 2018. ISSN 2312-3893. https://doi.org/10.18004/rvspmi/2312-3893/2018.05(01)59-070.
Introduction:
The practice of medicine frequently faces the management of female patients with uncomplicated urinary tract infection, in which an empirical treatment for Escherichia coli is needed, based on the identification of the so-called first-line antibiotics for this germ and in the knowledge of local resistance to them.
Objectives:
To analyze the texts of Internal Medicine, Nephrology, Microbiology, international guidelines and other recent publications to identify the following antibiotics as those of first line for the treatment of uncomplicated acute cystitis in women: nitrofurantoin, fosfomycin, cotrimoxazole (trimethoprim -sulfamethoxazole) and pivmecillinam.
Results:
Of the above mentioned antibiotics, only nitrofurantoin and cotrimoxazole are available in Paraguay. In a study we recently published it was found that the resistance of E. coli to nitrofurantoin was 4% and to cotrimoxazole 35%.
Conclusion:
Of the antibiotics considered as of first line for the empirical treatment of uncomplicated acute cystitis in women, only nitrofurantoin and cotrimoxazole are available in the country, being low (4%) the local resistance of E. coli to nitrofurantoin and high (35%) to cotrimoxazole.
Keywords : cystitis; Escherichia coli; nitrofurantoin; trimethoprim and sulfamethoxazole combination; microbial pharmacoresistance; urinary infections.