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January 8, 1996

Uncomplicate the Treatment of Uncomplicated Urinary Tract Infections-Reply

Arch Intern Med. 1996;156(1):112-113. doi:10.1001/archinte.1996.00440010131021

The concerns expressed by Ditmanson and Apgar regarding the use of ciprofloxacin as a short-course, low-dose treatment for uncomplicated urinary tract infections in otherwise healthy women are well expressed and not unexpected. Nevertheless, their generalizations about the problem of antimicrobial resistance should be dispelled by examination of available data. Certain microorganisms such as S aureus and P aeruginosa have been associated with development of quinolone resistance in the United States, usually in the hospital setting. However, there has been no significant development of resistance to the fluoroquinolones among the Enterobacteriaceae.1 The issue of "inappropriate use" and, in particular, the anecdotal cases of treatment failures associated with S pneumoniae are not related to development of drug resistance. In fact, while the increasing resistance of S pneumoniae to penicillin is of great concern, there has been no change in the susceptibility of this organism to the quinolones, despite the significant use