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Salam ME, Jeffres M, Molina KC, Miller MA, Huang M, Fish DN. Evaluation of Oral Amoxicillin/Clavulanate for Urinary Tract Infections Caused by Ceftriaxone Non-Susceptible Enterobacterales. Pharmacy (Basel) 2024; 12:60. [PMID: 38668086 PMCID: PMC11054542 DOI: 10.3390/pharmacy12020060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/19/2024] [Accepted: 03/24/2024] [Indexed: 04/29/2024] Open
Abstract
Urinary tract infections (UTIs) are one of the most common infections and are frequently caused by Gram-negative organisms. The rise of resistant isolates has prompted evaluation of alternative therapies, including amoxicillin-clavulanate which has potent activity against Ambler class A enzymes. This study sought to evaluate clinical outcomes of patients with ceftriaxone non-susceptible UTIs receiving amoxicillin-clavulanate or standard of care (SOC). This was a single-center, retrospective, cohort study of adult patients with urinary tract infections caused by a ceftriaxone non-susceptible pathogen who received amoxicillin-clavulanate or SOC. The primary outcome was clinical failure at 90 days. Secondary outcomes included time to failure, isolation of a resistant organism, and hospital length of stay. Fifty-nine patients met study inclusion: 26 received amoxicillin/clavulanate and 33 received SOC. Amoxicillin-clavulanate recipients did not have higher failure rates compared to SOC recipients. For patients requiring hospital admission, hospital length of stay was numerically shorter with amoxicillin-clavulanate. The frequency of amoxicillin-clavulanate and carbapenem-resistant organisms did not differ significantly between groups. Amoxicillin-clavulanate may be a useful alternative therapy for the treatment of ceftriaxone non-susceptible Enterobacterales UTIs.
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Affiliation(s)
- Madison E. Salam
- Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO 80045, USA; (M.E.S.); (M.J.)
- Department of Pharmacy, UCHealth University of Colorado Hospital, Aurora, CO 80045, USA
| | - Meghan Jeffres
- Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO 80045, USA; (M.E.S.); (M.J.)
- Department of Pharmacy, UCHealth University of Colorado Hospital, Aurora, CO 80045, USA
| | - Kyle C. Molina
- Department of Pharmacy, Scripps Health, La Jolla, CA 92121, USA
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA
| | - Matthew A. Miller
- Department of Pharmacy, Children’s Hospital Colorado, Aurora, CO 80045, USA;
| | - Misha Huang
- Division of Infectious Diseases, Department of Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA;
- Department of Medicine–Infectious Diseases, UCHealth University of Colorado Hospital, Aurora, CO 80045, USA
| | - Douglas N. Fish
- Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO 80045, USA; (M.E.S.); (M.J.)
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