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The Choice of Empirical Treatment of Uncomplicated Cystitis: No Longer Free Ride
Tae Hyong Kim
Department of Internal Medicine, Soon Chun Hyang University Seoul Hospital, Seoul, Korea
Vol.44 Num.4 (p323~327)
Resistance of uropathogenic E. coli to trimethoprim/sulfamethoxazole in Korea has surpassed the threshold of 20% at which the drug is no longer recommended for empirical treatment and routine urine culture is recommended. Given the unavailability of alternative agents other than fluoroquinolones, increased use of this agent, which is known to cause collateral damage, appears inevitable. However, the majority of study data have been reported from studies of pyelonephritis, and seldom represent the level of resistance of community acquired uncomplicated cystitis. For selection of a rational empirical agent according to the guidelines, judicious interpretation of recent studies conducted in Korea with regard to quality of the evidence is required.
Keywords : Cystitis, Pyelonephritis, Drug resistance, Quinolone