Abstract:
Urinary tract infections (UTIs) are among the most common infectious diseases occurring in
either the community or healthcare settings. A wide variety of bacteria are responsible for
causing UTIs, however extra-intestinal pathogenic E. coli or ExPEC) remains the most common
etiological agent. Since 2000, resistance to antibiotics emerged globally among ExPEC and is
causing delays in appropriate therapy with subsequent increased morbidity and mortality. For
patients with acute uncomplicated lower UTIs, nitrofurantoin, trimethoprim-sulfamethoxazole,
fosfomycin or pivmecillinam should be prescribed for a 1-5 day course depending on the agent
used. Single-dose fosfomycin is an excellent option for uncomplicated lower UTIs and has had
similar clinical and/or bacteriological efficacy for 3- or 7-day regimens for alternate agents (i.e.,
ciprofloxacin, norfloxacin, cotrimoxazole or nitrofurantoin). The aim of this review article is to
provide an overview on the definitions, etiology, treatment guidelines (including agents for infections due to antimicrobial resistant bacteria) of lower UTIs and to highlight recent aspects
on antimicrobial resistance of ExPEC.
