Faculty Information |
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Language | Japanese |
The announcement title | JAID/JSC guidelines to treat urinary tract infections 2022: messages from the working group: Uncomplicated and complicated cystitis |
Academic Society name | The 110th Annual Meeting of the Japanese Urological Association |
Conference Type | Domestic Society |
Invitation | Invitation |
Announcement form | Oral presentation |
Presentation Type | Symposium/Workshop/Panel Discussion |
Lecture Type | シンポジウム・ワークショップ パネル(指名) |
Publisher and common publisher | Yamamoto Shingo |
Date | 2023/04/21 |
Country | Japan |
Venue (city and name of the country) |
Kobe |
Holding period | 2023/04/20~2023/04/23 |
Society abstract | SY28-1 2023 |
Description | In premenopausal women with acute uncomplicated cystitis, the isolation frequency of gram-positive cocci is relatively high (20-30%), making cephalosporins less effective. The previous reports demonstrated that penicillin with BLI (beta- lactamase inhibitor), cephalosporins, and quinolones all have susceptibility rates of 90% or higher. However, in 2021, a retrospective multicenter study reported that the proportion of quinolone-resistant E. coli is increasing in premenopausal women as well, at 15.4%, and quinolone should no longer be recommended. In postmenopausal women, gram-positive cocci are isolated less frequently (<10%) in acute uncomplicated cystitis than in premenopausal women. Since antimicrobial-resistant bacteria are detected more frequently in postmenopausal women (about 10% of ESBL-producing and 20% of quinolone-resistance among E. coli strains), urine culture and antimicrobial susceptibility testing should be performed prior to administration of antimicrobial agents.
Thus, in both premenopausal and postmenopausal women with uncomplicated cystitis, when the causative organism is unknown, penicillin with BLI which are expected to be effective against ESBL-producing gram-negative rods as well as gram-positive cocci, should be the first choice. When gram-positive cocci are suspected or detected, quinolones should be administered. Oral antimicrobial agents such as faropenem and formycin, which are known to be effective against ESBL- producing bacteria, should be used in selected cases. |