From the Guidelines
The recommended treatment duration for a male patient with an ESBL-producing UTI is 7-14 days, depending on the severity of the infection and the patient's clinical response. According to the European Association of Urology guidelines on urological infections, published in 2024 1, the treatment duration should be closely related to the treatment of the underlying abnormality. For men, a treatment duration of 14 days is recommended when prostatitis cannot be excluded. However, when the patient is haemodynamically stable and has been afebrile for at least 48 hours, a shorter treatment duration of 7 days may be considered. Some key points to consider when treating ESBL-producing UTIs include:
- The microbial spectrum is greater than for uncomplicated UTIs, and antimicrobial resistance is more likely 1
- Appropriate management of the urological abnormality or the underlying complicating factor is mandatory 1
- Optimal antimicrobial therapy depends on the severity of the illness at presentation, as well as local resistance patterns and specific host factors 1
- A urine culture and susceptibility testing should be performed, and initial empiric therapy should be tailored and followed by administration of an appropriate antimicrobial agent for the uropathogen isolated 1
From the Research
Treatment Duration for Male Patients with ESBL-Producing UTI
- The recommended treatment duration for male patients with ESBL-producing UTI is not explicitly stated in the provided studies, but we can look at the treatment durations used in the studies:
- A study published in 2020 2 found that short courses of antimicrobial treatment (≤ 7 days) were effective in treating complicated UTIs caused by ESBL-producing Enterobacterales.
- Another study published in 2012 3 used a 14-day treatment duration with nitrofurantoin to treat lower urinary tract infections caused by ESBL-producing E. coli.
- It's worth noting that the treatment duration may depend on the severity of the infection, the patient's overall health, and the specific antibiotic used.
Antibiotic Treatment Options for ESBL-Producing UTI
- Several studies suggest that certain antibiotics, such as:
- However, the effectiveness of these antibiotics may vary depending on the specific strain of bacteria and the patient's individual circumstances.
Considerations for Treatment
- The studies suggest that the treatment of ESBL-producing UTI should be guided by antimicrobial susceptibility testing to ensure that the chosen antibiotic is effective against the specific strain of bacteria 2, 4, 5, 6.
- Additionally, the treatment duration and antibiotic choice may need to be adjusted based on the patient's response to treatment and the severity of the infection.