More Kidney Infections
In Women Becoming
NEW YORK(Reuters Health) - Bacteria that often cause kidney infections in women have developed resistance to a widely used antibiotic, pushing down cure rates and driving up healthcare costs, researchers at the University of California-Los Angeles (UCLA), report.
Another antibiotic, however, appears to be more effective in less time, according to a report in this week's issue of The Journal of the American Medical Association.
In a study of 255 women with a kidney infection (pyelonephritis), researchers found that the drug ciprofloxacin cured 95% of the women took it, compared with 83% of those on trimethoprim/sulfamethoxazole (TMP/SMX), a standard drug combination used to treat the infection. While bacterial resistance was behind most of the treatment failures with TMP/SMX, there was no evidence of resistance to ciprofloxacin, according to Dr. David Talan and his colleagues.
This study, Talan said in a statement, ``highlights the growing impact of bacterial resistance and the need to re-evaluate antibiotics and treatment.''
When bacteria are exposed to antibiotics, most are killed or disabled, but some may mutate into drug-resistant strains. One way this occurs is through patients' failure to finish all of the pills they are prescribed for an infection; although patients feel better, some bacteria may survive to develop into drug-resistant strains.
Pyelonephritis is a serious infection of the upper urinary tract and kidneys that causes symptoms such as fever, nausea and painful, frequent urination. In this study, more than 90% of cases were caused by E. coli bacteria. When Talan's team isolated the bacteria, they found that 18% were resistant to TMP/SMX; among patients from Western states, the resistance rate was 32%, compared with 7% and 14% in the East and Midwest, respectively.
Women on ciprofloxacin took the drug for 7 days, while those on TMP/SMX had 2 weeks of treatment. Ciprofloxacin is a more costly drug, but since women with infections resistant to TMP/SMX needed further care, their healthcare costs were 30% higher, on average.
Talan and his colleagues recommend that doctors re-evaluate the antibiotics they prescribe for kidney infection. In Western states, they note, TMP/SMX may ``no longer be appropriate'' as a first-line treatment.
Researchers at UCLA and the Centers for Disease Control and Prevention are looking into why TMP/SMX-resistance is so high in certain US regions.
SOURCE: The Journal of the American Medical Association 2000;283:1583-1590.


This Site Served by TheHostPros