Ertapenem: Komplike üriner sistem enfeksiyonları için yeni bir antibiyotik seçeneği

Abstract

Objective: The treatment of complicated urinary tract infections (UTIs) may require the use of a parenteral antimicrobial agent active against the extended spectrum |3 lactamases-producing urinary pathogens. The activity of ertapenem, a new once-a-day carbapenem, was investigated in pathogens isolated from complicated and non-complicated UTIs. Material and method: A total of 256 urinary pathogen were studied. The half of the strains were isolated from complicated and the others were from non-complicated UTIs within three months in our laboratory. The antimicrobial susceptibilities of all strains identified by conventional laboratory methods were investigated using the disc diffusion method following the reccomendations of CLSI. Results: The most common pathogen was E. coli in each two group (respectively 91 and 92 strains). Klebsiella pneumoniae and E. coli were the most common ESBL-producing bacteria. ESBL rates in two groups for E. coli and Klebsiella pneumoniae were 25%, 15% and 53%, 14% respectively. While the resistance rates in complicated UTIs pathogens were higher than non-complicated UTIs pathogens for several antibiotics (amoxycillin-clavulanate, amikacin, ceftriaxone, ciprofloxacin, cephoperazon-sulbactam, imipenem, piperacillin-tazobactam), the ertapenem resistance was low in two groups. Conclusion: Ertapenem, a new once-a-day, broad spectrum carbapenem which is highly effective on ESBL-producing bacteria, is a good alternative choisefor the treatment .of complicated UTIs due to low resistance rates.