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Cefaclor as a first-line treatment for acute uncomplicated cystitis: A retrospective single-center study

BMC Urology Apr 10, 2020

Koguchi D, et al. - As treatment of acute uncomplicated cystitis (AUC) is often done with providing wide-spectrum antibiotics for a long time, that results in the emergence of multi-drug resistant bacteria, researchers here examined if this issue can be mitigated using narrow-spectrum antibiotics. Further, they investigated the clinical efficacy of cefaclor in patients with AUC. In this retrospective review, they assessed the clinical data of 223 women with AUC who were treated with cefaclor. The dominant pathogen was Escherichia coli (n = 160; 68.6%), followed by Klebsiella species and E. coli-extended spectrum β-lactamase (ESBL) (n = 19; 8.1% and n = 18; 7.7%). Observations revealed overall success rate of 94.0% (n = 219) and cefazolin susceptibility rate of 84.1%; the susceptibility rate was close to that of levofloxacin (82.9%). In AUC patients, cefaclor exhibited excellent efficacy; it was identified as efficacious even in those with in vitro resistance to cefazolin or levofloxacin. Outcomes thereby suggest that consideration could be given to cefaclor as a first-line option in patients with AUC and a second-line option for those with levofloxacin treatment failure.

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