Austin Health

Title
Fluoroquinolone resistance in urinary tract infections: Epidemiology, mechanisms of action and management strategies.
Publication Date
2024-01
Author(s)
Thompson, Daryl
Xu, Jennifer
Ischia, Joseph J
Bolton, Damien M
Subject
acute pyelonephritis
chronic prostatitis
fluoroquinolone resistance
multidrug resistance
Type of document
Journal Article
OrcId
0000-0003-3787-7933
0000-0001-8452-0713
0000-0001-7177-3631
0000-0002-5145-6783
DOI
10.1002/bco2.286
Abstract
Fluoroquinolone resistance is an issue of concern amongst physicians worldwide. In urology, fluoroquinolones are often used in the treatment of acute pyelonephritis and prostatitis, as well as infections caused by multidrug-resistant pathogens. We aim to highlight the importance of antimicrobial stewardship and the need for ongoing biomedical research to discover novel agents in our losing battle against resistant pathogens. In this review, we survey the literature and summarise fluoroquinolone resistance as it pertains to pyelonephritis and prostatitis, as well as alternative treatment strategies and prevention of multidrug resistance. The rise of fluoroquinolone resistance in bacteria has reduced the available treatment options, often necessitating hospital admission for intravenous antibiotics, which places an additional burden on both patients and the healthcare system. Many countries such as Australia have attempted to limit fluoroquinolone resistance by imposing strict prescribing criteria, though these efforts have not been entirely successful. Solutions to overcome resistance include prevention, combination therapy and the development of novel antimicrobial agents. Prevention of the proliferation of resistant organisms by antimicrobial stewardship is paramount, and urologists are obliged to be aware of responsible prescribing practices such as referring to local guidelines when prescribing. By reserving fluoroquinolones for infections in which they are truly indicated and by prescribing based on both patient and local environmental factors, we can preserve this effective resource for future use.
Link
Citation
BJUI Compass 2024-01; 5(1)
Jornal Title
BJUI Compass
ISSN
2688-4526

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