ArticlePloS one2014
High rate of per oral mecillinam treatment failure in community-acquired urinary tract infections caused by ESBL-producing Escherichia coli.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01838213 (Extended Spectrum Beta-lactamases - Treatment, Carriage, Environmental Dissemination And Population Epidemiology), which is not on this map. Cited by 25 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Extended Spectrum Beta-lactamases - Treatment, Carriage, Environmental Dissemination And Population Epidemiology
Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 81 citations in OpenAlex.
- Evaluation of the health and healthcare system burden due to antimicrobial-resistant Escherichia coli infections in humans: a systematic review and meta-analysis.Antimicrobial resistance and infection control · 2020Pooled it
- Implications of Antibiotic Resistance for Patients' Recovery From Common Infections in the Community: A Systematic Review and Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Pooled it
- The efficacy of pivmecillinam: 3 days or 5 days t.i.d against community acquired uncomplicated lower urinary tract infections - a randomized, double-blinded, placebo-controlled clinical trial study protocol.BMC infectious diseases · 2016Trial
- New Perspectives on Antimicrobial Agents: Pivmecillinam.Antimicrobial agents and chemotherapy · 2025Review
- WGS of intrauterinemBio · 2024Article
- Treatment, outcomes and characterization of pathogens in urinary tract infections caused by ESBL-producing Enterobacterales: a prospective multicentre study.The Journal of antimicrobial chemotherapy · 2024Article
- Assessing the impact of discordant antibiotic treatment on adverse outcomes in community-onset UTI: a retrospective cohort study.The Journal of antimicrobial chemotherapy · 2024Article
- Article
- Prior Antibiotic Use Increases Risk of Urinary Tract Infections Caused by ResistantAntibiotics (Basel, Switzerland) · 2022Article
- Reviving the role of mecillinam against extended spectrum beta-lactamase producing enterobacterales.Iranian journal of microbiology · 2022Article
- Molecular identification ofJournal of advanced veterinary and animal research · 2022Article
- Effectiveness of oral antibiotics for treating pyelonephritis caused by extended-spectrum beta-lactamase-producingJournal of general and family medicine · 2020Article
- Susceptibility of Clinical Enterobacterales Isolates With Common and Rare Carbapenemases to Mecillinam.Frontiers in microbiology · 2020Article
- Three versus five days of pivmecillinam for community-acquired uncomplicated lower urinary tract infection: A randomised, double-blind, placebo-controlled superiority trial.EClinicalMedicine · 2019Article
- Results from a ProspectiveAntimicrobial agents and chemotherapy · 2019Article
- Phenotypic and Molecular Epidemiology of ESBL-, AmpC-, and Carbapenemase-ProducingFrontiers in microbiology · 2019Article
- Pivmecillinam compared to other antimicrobials for community-acquired urinary tract infections withInfection and drug resistance · 2019Article
- Bacteriology in uncomplicated urinary tract infections in Norwegian general practice from 2001-2015.BJGP open · 2018Article
- Mecillinam for the treatment of acute pyelonephritis and bacteremia caused by Enterobacteriaceae: a literature review.Infection and drug resistance · 2018Review
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A population-based study was performed to investigate the efficacy of mecillinam treatment of community-acquired urinary tract infections (CA-UTI) caused by extended-spectrum β-lactamase (ESBL) producing Escherichia coli. The study was conducted in South-Eastern Norway. Data from patients with CA-UTI caused by ESBL-producing and non-producing (random controls) E. coli were collected through interviews, questionnaires, medical records and the Norwegian Prescription Database. Treatment failure was defined as a new antibiotic prescription appropriate for UTI prescribed within two weeks after the initial antimicrobial therapy. Multivariable logistic regression analysis was performed to identify treatment agents and patient- or bacterial traits associated with treatment failure. A total of 343 patients (mean age 59) were included, of which 158 (46%) were treated with mecillinam. Eighty-one patients (24%, mean age 54) had infections caused by ESBL producing E. coli, and 41 of these patients (51%) received mecillinam as the primary treatment. Mecillinam treatment failure was observed in 18 (44%) of patients infected by ESBL-producing strains and in 16 (14%) of patients with a CA-UTI caused by ESBL non-producing strains. Multivariable analysis showed that ESBL status (odds ratio (OR) 3.2, 95% confidence interval (CI) 1.3-7.8, p = 0.009) and increased MIC of mecillinam (OR 2.0 for each doubling value of MIC, CI 1.4-3.0, p<0.001) were independently associated with mecillinam treatment failure. This study showed a high rate of mecillinam treatment failure in CA-UTIs caused by ESBL producing E. coli. The high failure rate could not be explained by the increased MIC of mecillinam alone. Further studies addressing the use of mecillinam against ESBL-producing E. coli, with emphasis on optimal dosing and combination therapy with β-lactamase inhibitors, are warranted.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.