From the Guidelines
Augmentin (amoxicillin-clavulanate) is not the first-line treatment for uncomplicated catheter-associated urinary tract infection (CAUTI) due to its inferior efficacy and higher propensity for adverse effects compared to other recommended agents. When considering treatment options for CAUTI, it's essential to prioritize agents with minimal resistance and collateral damage. According to the guidelines 1, nitrofurantoin monohydrate/macrocrystals, trimethoprim-sulfamethoxazole, and fosfomycin trometamol are preferred choices due to their efficacy and lower resistance rates. Some key points to consider when treating CAUTI include:
- The choice of antibiotic should be based on local resistance rates and the susceptibility of the infecting strain 1.
- Fluoroquinolones, such as ofloxacin, ciprofloxacin, and levofloxacin, are highly efficacious but should be reserved for important uses other than acute cystitis due to their propensity for collateral damage 1.
- Beta-lactam agents, including amoxicillin-clavulanate, can be used when other recommended agents cannot be used, but they generally have inferior efficacy and more adverse effects 1. It's crucial to note that amoxicillin or ampicillin should not be used for empirical treatment due to their relatively poor efficacy and high prevalence of antimicrobial resistance worldwide 1. In the context of CAUTI treatment, the use of Augmentin (amoxicillin-clavulanate) should be cautious and reserved for cases where other recommended agents are not suitable, and its use should be guided by culture results and local resistance patterns whenever possible.
From the Research
Treatment of Uncomplicated Catheter-Associated Urinary Tract Infection (CAUTI)
- The treatment of uncomplicated CAUTI typically involves the use of antibiotics, with the choice of antibiotic depending on the suspected or confirmed causative organism and local susceptibility patterns 2.
- According to the study published in 2020, second-line options for treating UTIs include oral cephalosporins, fluoroquinolones, and β-lactams, such as amoxicillin-clavulanate 2.
- Amoxicillin-clavulanate is also listed as a treatment option for UTIs due to ESBLs-E coli and ESBLs- Klebsiella pneumoniae 2.
Efficacy of Augmentin (Amoxicillin-Clavulanate) in Treating UTIs
- A study published in 1982 found that Augmentin (amoxycillin and clavulanic acid) is effective in treating urinary tract infections, with a success rate of about 70 per cent for amoxycillin-resistant organisms 3.
- Another study published in 1985 found that the amoxicillin-clavulanic acid combination is active against certain strains of hospital isolates, including penicillinase-producing Staphylococci and some Enterobacteriaceae 4.
Considerations for Using Augmentin to Treat CAUTI
- The use of Augmentin to treat CAUTI should be guided by local susceptibility patterns and the suspected or confirmed causative organism 2.
- It is essential to use antibiotics wisely to avoid the development of resistance, particularly in the treatment of UTIs caused by multidrug-resistant organisms 2.