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Revista Virtual de la Sociedad Paraguaya de Medicina Interna

On-line version ISSN 2312-3893


MELGAREJO MARTINEZ, Laura Elizabeth et al. Use of second-line antibiotics for the treatment of uncomplicated acute cystitis in women: current approach. Rev. virtual Soc. Parag. Med. Int. [online]. 2018, vol.5, n.2, pp.62-72.  Epub Sep 01, 2018. ISSN 2312-3893.

Background and objective:

With this study we intended to identify the second-line antibiotics to be used in urinary tract infections (UTI), specifically in uncomplicated cystitis of women. Later, we proposed to present the prevalence of resistance to the second-line antibiotics of the germs most frequently found in the UTI in the Microbiology Laboratory of the Faculty of Medical Sciences of the National University of Asunción.

Material and method:

An observational, descriptive, cross-sectional study was carried out.


Escherichia coli has a resistance to cefuroxine lower than 20% on average, which was maintained in the observed period (2010-2017). The resistance to ampicillin-sulbactam of this germ is varying, from a high resistance in the first years of the observation to a progressive approach to 30% in the preceding years (on average 34%). Resistance to ciprofloxacin presents a rate higher than 25% in the studied years. Regarding the resistance of Klebsiella pneumoniae to the second-line antibiotics, a resistance greater than 30% was found for the group of cephalosporins, ampicillin sulbactam and ciprofloxacin in the last two years of observation.


The data show an important resistance of Escherichia coli and Klebsiella pneumoniae isolated in urine cultures to the second-line antibiotics for the treatment of uncomplicated cystitis in women. Therefore, a great weight should be given to the results of the urine cultures for the proper use of these antibiotics.

Keywords : cystitis; Escherichia coli; Klebsiella pneumoniae; quinolones; microbial drug resistance; urinary tract infections; bacterial drug resistance.

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