Malik RD, et al. - This review was performed to assess the effect of antibiotic allergy and resistance on suitable oral antibiotic treatment choice for recurrent urinary tract infections (RUTIs) in older women. Findings demonstrated that non-availability of several first-line antibiotics for this group of patients was ascribed to allergy and/or antibiotic resistance. Nitrofurantoin was identified as the only viable alternative in nearly a third of women.

Methods

• Researchers obtained demographic data, known drug allergies, renal function, antibiotic susceptibility of most recent urine culture, allergy and/or resistance to trimethoprim-sulfamethoxazole (TMP-SMX), fluoroquinolones, and nitrofurantoin in this review of a prospectively maintained database of women 65 years old and older with documented RUTIs (≥3 UTI/year) and trigonitis on cystoscopy.

Results

• Data reported that a total of 86 women with RUTIs met study crtieria from 2006-2014.
• Findings demonstrated that mean age was 77.9±7.8 and 94% were Caucasians.
• In 94%, an eGFR >30mL/min was noted.
• Researchers observed that the percentage of women allergic, resistant, or both allergic and resistant to TMP-SMX was 33%, 29%, and 15%, to fluoroquinolones was 14%, 34%, and 8.1%, or nitrofurantoin was 16%, 14%, and 5% respectively.
• They also noted that sensitivity to nitrofurantoin was displayed by 28% (24/86) of women who were allergic and/or resistant to TMP-SMX and fluoroquinolones.
• Data reported that 20% (17/86) were allergic and/or resistant to all three antibiotics.
• A significantly higher number of other antibiotic resistances were observed among women who were allergic or resistant to TMP-SMX vs women sensitive to TMP-SMX (4.9±3.6 vs 2.1±2.3; p < 0.0001).
• Similarly, significantly more antibiotic resistances were seen in women with fluoroquinolone allergy or resistance as compared with those who were fluoroquinolone sensitive (5.8±3.5 vs 2.3±2.5; p < 0.0001).