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For instructor materials including Power Points, Answers to Clinical Encounter Questions, please contact [email protected].
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Content Update
July 02, 2025
Gepotidacin: A Novel Drug for Uncomplicated Urinary Tract Infections: Gepotidacin is a type IIA topoisomerase inhibitor approved for the treatment of uncomplicated urinary tract infections (UTIs) in nonpregnant women and girls 12 years or older weighing greater than 40 kg. Oral gepotidacin is an alternative option that can be utilized in patients with contraindications to first-line agents or UTIs that are resistant to those agents. Gepotidacin should be carefully utilized, following evidence-based guidelines and antimicrobial stewardship to prevent further resistance that could emerge from overuse in the community.
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Content Update
December 18, 2024
Cefepime/enmetazobactam in the treatment of complicated urinary tract infections or acute pyelonephritis: Cefepime/enmetazobactam combines a fourth-generation cephalosporin with a novel beta lactamase inhibitor and is approved the U.S. Food and Drug Administration for complicated urinary tract infections or acute pyelonephritis. This combination antibiotic will provide an additional option for multidrug-resistant gram-negative pathogens.
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Content Update
June 24, 2024
Pivmecillinam: A Newly Approved Penicillin Antibiotic: In April of 2024, the beta-lactam antibiotic, pivmecillinam, a prodrug of mecillinam, was approved by the United States Food and Drug Administration for the treatment of uncomplicated urinary tract infections in female adults 18 years of age and older.
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Content Update
January 09, 2023
Updates in the Management of AmpC-producing Enterobacterales: AmpC β-lactamase-producing Enterobacterales (AmpC-E) are gram-negative enteric bacteria commonly implicated in urinary tract and intra-abdominal infections. Recently published Infectious Diseases Society of America guidance deemphasized certain bacteria (e.g., Serratia spp., Morganella spp., etc.) historically considered clinically relevant AmpC-E, and highlighted three species (Enterobacter cloacae complex, Citrobacter freundii, and Klebsiella aerogenes) as being at moderate-high risk of inducible AmpC production. Authors addressed roles in therapy of workhorse β-lactams including ceftriaxone, cefepime, piperacillin-tazobactam, and carbapenems – as well as the role of non-β-lactam antibiotics. Recommendations which may constitute significant changes to the practice of some clinicians include consideration of third-generation cephalosporins for treatment of organisms at lower risk of AmpC production, preferential use of carbapenems for AmpC-E with susceptible-dose-dependent cefepime minimum inhibitor concentrations (MICs) of 4-8 mcg/mL, and suggestion against use of piperacillin-tazobactam for most AmpC-E infections.
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LEARNING OBJECTIVES
Upon completion of the chapter, the reader will be able to:
Determine the diagnostic criteria for significant bacteriuria, urinary tract infections (UTIs), and catheter-associated UTIs.
Recognize the signs and symptoms of UTIs, and differentiate asympotomatic bacteriuria from acute cystitis and pyelonephritis and acute prostatitis from chronic prostatitis.
Identify the pathogenic organisms most commonly implicated in different UTIs.
Assess the laboratory tests used in the diagnosis of UTIs.
Based on clinical signs, symptoms, and laboratory parameters, recommend appropriate empiric and targeted pharmacotherapy for the treatment of acute cystitis, pyelonephritis, and prostatitis, including drug, dose, and duration of therapy.
Formulate appropriate monitoring and education information for patients with ...