Nicoletti et al identified risk factors for ciprofloxacin-resistant Escherichia coli (E. coli) causing urinary tract infections (UTIs). This can help to identify a patient who may need more aggressive management. The authors are from University Hospital Zurich in Switzerland.


Patient selection: urinary tract infection with E. coli


Outcome: fluoroquinolone resistance


Fluroquinolones were used as the empiric antibiotic of choice in most acute, uncomplicated urinary tract infections


Risk factors for ciprofloxacin-resistant E. coli

(1) prior therapy with fluoroquinolone antibiotics

(2) prior urinary tract catheterization

(3) recurrent urinary tract infections



(1) Antibiotic resistance should be considered if the patient has one or more risk factors or if the patient does not respond as expected to therapy.

(2) Urine culture with antibiotic susceptibility should be performed whenever possible to help to guide therapy.

(3) The prevalence of various antibiotic resistance patterns in the community should be monitored.


Additional questions (not mentioned in the article):

(1) Could there be referral bias for a university clinic versus the general community?

(2) Could the university hospital serve as the site of exposure?


To read more or access our algorithms and calculators, please log in or register.