The place of cephalosporins in the treatment of lower urinary tract infection
DOI: 10.32364/2587-6821-2023-7-4-212-217
A.V. Kuzmenko, V.V. Kuzmenko, T.A. Gyaurgiev
N.N. Burdenko Voronezh State Medical University, Voronezh, Russian Federation
Therapy of lower urinary tract infections (LUTI), such as cystitis or asymptomatic bacteriuria, commonly turns out to be a more difficult task in practice than it seems at first glance. The choice of antibacterial drugs should be made taking into account their efficacy, proven in clinical studies, tolerability, adverse events, as well as their cost and availability. Numerous results of epidemiological studies indicate a steady increase in the resistance of uropathogens to antibiotics, which, in turn, leads to an increase in the number of cases of ineffective therapy and recurrent disease forms. When choosing an antibiotic, preference should be given to drugs with a low selection risk of resistant microorganisms and collateral damage development, such as fosfomycin and nitrofurans recommended as first-line therapy drugs. According to the current federal clinical guidelines, third-generation cephalosporins are recommended for use as an alternative therapy for LUTI, including in pregnant women, in allergies, intolerance, lack of sensitivity of the pathogen according to bacteria tests or previous ineffective treatment with first-line drugs. This article presents the literature data on the efficacy of the third-generation cephalosporin use in the treatment of LUTI.
Keywords: cystitis, lower urinary tract infection, uropathogens, cephalosporins, cefixime, clinical recommendations.
For citation: Kuzmenko A.V., Kuzmenko V.V., Gyaurgiev T.A. The place of cephalosporins in the treatment of lower urinary tract infection. Russian Medical Inquiry. 2023;7(4):–217 (in Russ.). DOI: 10.32364/2587-6821-2023-7-4-212-217.
About the authors:
Andrey V. Kuzmenko — Dr. Sc. (Med.), Professor of the Department of Urology, N.N. Burdenko Voronezh State Medical University; 10, Studentcheskaya str., Voronezh, 394036, Russian Federation; ORCID iD 0000-0002-7927-7015.
Vladimir V. Kuzmenko — Dr. Sc., Professor of the Department of Urology, N.N. Burdenko Voronezh State Medical University; 10, Studentcheskaya str., Voronezh, 394036, Russian Federation; ORCID iD 0000-0001-7803-8832.
Timur A. Gyaurgiev — C. Sc. (Med.), Associate Professor of the Department of Urology, N.N. Burdenko Voronezh State Medical University; 10, Studentcheskaya str., Voronezh, 394036, Russian Federation; ORCID iD 0000-0002-2209-6264.
Contact information: Andrey V. Kuzmenko, e-mail: kuzmenkoav09@yandex.ru.
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interests.
Received 13.03.2023.
Revised 03.04.2023.
Accepted 29.04.2023.
2. Sigitova O.N. Urinary tract infections. In: General medical practice. National leadership. In 2 volumes. Kuznetsova O.Yu., Lesnyak O.M., Frolova E.V., eds. T.1. M.: GEOTAR-Media; 2020:655–678 (in Russ.).
3. Zaytsev A.V., Shiryaev A.A., Kim Yu.A. et al. I Urinary tract infections. Modern tactics of a urologist. RMJ. 2019;1:21–26 (in Russ.).
4. Sursyakova K.I., Safyanova T.V. Some Epidemiological Aspects of Infections of Urinary Tract in patients of Altai Regional Hospital for Veterans of Wars. Epidemiology and Vaccinal Prevention. 2019;18(1):105–111 (in Russ.). DOI: 10.31631/2073-3046-2019-18-1-105-111.
5. Lee D.S., Lee S.J., Choe H.S. Community-Acquired Urinary Tract Infection by Escherichia coli in the Era of Antibiotic Resistance. Biomed Res Int. 2018;2018:7656752. DOI: 10.1155/2018/7656752.
6. Bonkat G., Wagenlehner F. In the Line of Fire: Should Urologists Stop Prescribing Fluoroquinolones as Default? Eur Urol. 2019;75(2):205–207. DOI: 10.1016/j.eururo.2018.10.057.
7. Tandan M., Cormican M., Vellinga A. Adverse events of fluoroquinolones vs. other antimicrobials prescribed in primary care: A systematic review and meta-analysis of randomized controlled trials. Int J Antimicrob Agents. 2018;52(5):529–540. DOI: 10.1016/j.ijantimicag.2018.04.014.
8. Kabbani S., Hersh A.L., Shapiro D.J. et al. Opportunities to Improve Fluoroquinolone Prescribing in the United States for Adult Ambulatory Care Visits. Clin Infect Dis. 2018;67(1):134–136. DOI: 10.1093/cid/ciy035.
9. Perepanova T.S., Kozlov R.S., Rudnov V.A. et al. Antimicrobial therapy and prevention of infections of the kidneys, urinary tract and male genital organs. Federal clinical guidelines. M.: Uromedia; 2020 (in Russ.).
10. Palagin I.S., Suhorukova M.V., Dehnich A.V. et al. Current status of antibiotic resistance of nonhospital urinary tract pathogens in Russia: results of the DARMIS study (2010-2011)]. Clinical Microbiology and Antimicrobial Chemotherapy. 2012;14(4):280–302 (in Russ.).
11. McLellan L.K., Hunstad D.A. Urinary Tract Infection: Pathogenesis and Outlook. Trends Mol Med. 2016;22(11):946–957. DOI: 10.1016/j.molmed.2016.09.003.
12. Rafal'skiy V.V., Moiseeva E.M. Epidemiology of uncomplicated nosocomial urinary tract infections in the Russian Federation. Vestnik urologii. 2018;2:30–37 (in Russ.). DOI: 10.21886/2308-6424-2018-6-2-30-37.
13. Zyryanov S.K. Study of the comparative dissolution kinetics of cefixime preparations. Farmateka. 2016;10:67–71 (in Russ.).
14. Zyryanov S.K., Baybulatova Ye.A. The Use of New Dosage Forms of Antibiotics as a Way to Improve the Effectiveness and Safety of Antibiotic Therapy. Antibiotics and Chemotherapy. 2019;64(3-4):81–91 (in Russ.). DOI: 10.24411/0235-2990-2019-10020.
15. Yakovlev S.V. New Concept of Rational Use of Antibiotics in Outpatient Practice. Antibiotics and Chemotherapy. 2019;64(3-4):48–58 (in Russ.). DOI: 10.24411/0235-2990-2019-100017.
16. Orlova N.V. Antibiotic resistance and modern strategy of antibacterial therapy. Meditsinskiy sovet. 2022;(8):89–97 (in Russ.). DOI: 10.21518/2079-701X-2022-16-8-89-97.
17. Brogden R.N., Campoli-Richards D.M. Cefixime. A review of its antibacterial activity. Pharmacokinetic properties and therapeutic potential. Drugs. 1989;38(4):524–550. DOI: 10.2165/00003495-198938040-00004.
18. Faulkner R.D., Bohaychuk W., Desjardins R.E. et al. Pharmacokinetics of cefixime after once-a-day and twice-a-day dosing to steady state. J Clin Pharmacol. 1987;27(10):807–812. DOI: 10.1002/j.1552-4604.1987.tb03001.x.
19. Matsumoto Y., Kojo H., Kamimura T. et al. The mechanism of action of cefixime, a new oral cephalosporin. Chemotherapy. 1985;33:123–133. DOI: 10.11250/chemotherapy1953.33.Supplement6_123.
20. Neu H.C. In vitro activity of a new broad spectrum, beta-lactamase-stable oral cephalosporin, cefixime. Pediatr Infect Dis J. 1987;6(10):958–962. DOI: 10.1097/00006454-198710000-00034.
21. Asbach H.W. Single dose oral administration of cefixime 400mg in the treatment of acute uncomplicated cystitis and gonorrhoea. Drugs. 1991;42 Suppl 4:10–13. doi: 10.2165/00003495-199100424-00005.
22. Iravani A., Richard G.A., Johnson D., Bryant A. A double-blind, multicenter, comparative study of the safety and efficacy of cefixime versus amoxicillin in the treatment of acute urinary tract infections in adult patients. Am J Med. 1988;85(3A):17–23. DOI: 10.1016/0002-9343(88)90459-7.
23. Rafal'skiy V.V., Belokrysenko S.S., Malev I.V. et al. Sensitivity of pathogens of urinary tract infections to cefixime. Lechashchiy vrach. 2008;8:89–91 (in Russ.).
24. Galkin V.V., Dovgan E.V., Kozlov S.N., Rafalsky V.V. Cefixime in comparison with ciprofloxacin in acute uncomplicated cystitis: a clinical and economic study. Clinical Microbiology and Antimicrobial Chemotherapy. 2012;1:50–66 (in Russ.).
25. Yamamoto M., Yoshida T., Ohishi K. et al. Fundamental and clinical studies of cefixime, a new oral cephalosporin. Chemotherapy. 1985;33:459–469. DOI: 10.11250/chemotherapy1953.33.Supplement6_459.
26. Hasegawa Y., Fujimoto Y., Takeda A. et al. Usefulness of cefixime in urinary tract infection fundamental study with in vitro model of urinary bladder and clinical study. Chemotherapy. 1985;33:650–666. DOI: 10.11250/chemotherapy1953.33.Supplement6_650.
27. Kishi H., Kitahara K., Tominaga T., Niijima T., Nishimura Y. et al. Experimental and clinical studies on cefixime in urinary tract infections. Chemotherapy 1985;33:541–558.
28. Seko S., Sumii T., Nakano H. et al. Clinical studies of cefixime in the urological field. Chemotherapy. 1985;33:735–750. DOI: 10.11250/chemotherapy1953.33.Supplement6_735.
29. Washida H., Tsugaya M., Iwase Y. et al. Clinical studies of cefixime in the treatment of urinary tract infections. Chemotherapy. 1985;33:667–694. DOI: 10.11250/chemotherapy1953.33.Supplement6_667.
30. Kameoka H., Takano Y., Miyoshi S. et al. [Clinical experience with cefixime in urinary tract infections]. Jpn J Antibiot. 1989;42(12):2540–2547 (in Japanese). PMID: 2614911.
31. Chilova R.A., Ishchenko A.I., Antonovich N.I. Antimicrobial therapy of urinary tract infections in pregnant women: a multicenter pharmacoepidemiological study. Zhurnal akusherstva i zhenskikh bolezney. 2006;1:38–43 (in Russ.).
32. Savenkova M.S. Significance and place of third-generation oral cephalosporins in pediatric practice. Consilium medicum. Pediatriya. 2007.
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