ArticleJAC-antimicrobial resistance2025
Co-resistance between oral antibiotics for pyelonephritis and those for cystitis-applying an escalation antibiogram model to local community data.
Article in JAC-antimicrobial resistance, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
6 authors.
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Abstract
Objectives: We applied an escalation antibiogram to community urine data to assess how presumptive resistance to first-line antibiotics for cystitis affects resistance to antibiotics used to treat pyelonephritis. Methods: We extracted susceptibility data from Results: Resistance to cystitis antibiotics has a marked effect on the probability of resistance to oral antibiotics used to treat pyelonephritis. In particular, amoxicillin/clavulanate should be avoided for pyelonephritis if resistance to pivmecillinam is presumed, because predicted resistance rates exceed 50%. For patients with presumed resistance to nitrofurantoin or trimethoprim, the optimal pyelonephritis antibiotic depends on both age group and history of past infections. Conclusions: Analysis using an escalation antibiogram informed by our Bayesian model is a useful tool to support empirical antibiotic prescribing for pyelonephritis. It provides an estimate of local resistance rates and a comparison of antibiotic options with a measure of the uncertainty in the data.
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