Evidence map›Paper›PMID 26607324›Full record

SynthesisBMC infectious diseases2015

Ciprofloxacin resistance in community- and hospital-acquired Escherichia coli urinary tract infections: a systematic review and meta-analysis of observational studies.

Oyebola Fasugba, Anne Gardner, Brett G Mitchell, George Mnatzaganian

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC infectious diseases, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 92 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
92citing papers in PubMed, 3 pooled it
10.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

92 citing papers in PubMed, 3 syntheses or guidelines pooled it, 211 citations in OpenAlex.

  1. Pooled it
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  15. Article
  16. Antimicrobial ResistantPathogens (Basel, Switzerland) · 2025
    Review
  17. Article
  18. Fluoroquinolone Resistance inMicroorganisms · 2024
    Review
  19. Investigating trends in antibiotic resistance ofMicrobiology (Reading, England) · 2024
    Article
  20. Article

32 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Oyebola FasugbaFaculty of Health Sciences, Australian Catholic University, 223 Antill Street, Watson, Australian Capital Territory, 2602, Australia. oyebola.fasugba@myacu.edu.au.
Anne GardnerFaculty of Health Sciences, Australian Catholic University, 223 Antill Street, Watson, Australian Capital Territory, 2602, Australia. anne.gardner@acu.edu.au.
Brett G MitchellFaculty of Health Sciences, Australian Catholic University, 223 Antill Street, Watson, Australian Capital Territory, 2602, Australia. brett.mitchell@avondale.edu.au.
George MnatzaganianSchool of Allied Health, Faculty of Health Sciences, Australian Catholic University, 17 Young Street, Fitzroy, Victoria, 3065, Australia. george.mnatzaganian@acu.edu.au.
Australian Catholic University · AUAvondale University · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDuring the last decade the resistance rate of urinary Escherichia coli (E. coli) to fluoroquinolones such as ciprofloxacin has increased. Systematic reviews of studies investigating ciprofloxacin resistance in community- and hospital-acquired E. coli urinary tract infections (UTI) are absent. This study systematically reviewed the literature and where appropriate, meta-analysed studies investigating ciprofloxacin resistance in community- and hospital-acquired E. coli UTIs.

methodsObservational studies published between 2004 and 2014 were identified through Medline, PubMed, Embase, Cochrane, Scopus and Cinahl searches. Overall and sub-group pooled estimates of ciprofloxacin resistance were evaluated using DerSimonian-Laird random-effects models. The I(2) statistic was calculated to demonstrate the degree of heterogeneity. Risk of bias among included studies was also investigated.

resultsOf the identified 1134 papers, 53 were eligible for inclusion, providing 54 studies for analysis with one paper presenting both community and hospital studies. Compared to the community setting, resistance to ciprofloxacin was significantly higher in the hospital setting (pooled resistance 0.38, 95% CI 0.36-0.41 versus 0.27, 95% CI 0.24-0.31 in community-acquired UTIs, P < 0.001). Resistance significantly varied by region and country with the highest resistance observed in developing countries. Similarly, a significant rise in resistance over time was seen in studies reporting on community-acquired E. coli UTI.

conclusionsCiprofloxacin resistance in E. coli UTI is increasing and the use of this antimicrobial agent as empirical therapy for UTI should be reconsidered. Policy restrictions on ciprofloxacin use should be enhanced especially in developing countries without current regulations.

Indexed as

Drug Resistance, BacterialAnti-Bacterial AgentsCiprofloxacinCommunity-Acquired InfectionsEscherichia coliEscherichia coli InfectionsHumansObservational Studies as TopicUrinary Tract InfectionsAnti-Bacterial AgentsCiprofloxacin

Identifiers

PMID26607324
PMCPMC4660780
OpenAlexW2179949285

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.