Escherichia coli is the most commonly isolated bacterium in
urinary tract infections, especially in acute uncomplicated
cystitis. It is reported that
fluoroquinolone-resistant E. coli is increasing. However, according to the guidelines for antimicrobial use published by the Japanese Associations for
Infectious Diseases (JAID) and the Japanese Society of
Chemotherapy (JSC) in 2014, the first line antimicrobial regimen for the treatment of acute uncomplicated
cystitis is a 3-day regimen with
fluoroquinolone. We analyzed the causative bacteria and clinical efficacy of antimicrobial treatment in acute uncomplicated
cystitis cases at our institute. Patients diagnosed as having acute uncomplicated
cystitis who had ≥ 10(4) colony-forming units/mL of bacteria in their midstream urine in our outpatient clinic between 2012 and 2013 were enrolled in this study. We analyzed their clinical data retrospectively. From 173 patients, 212 strains were isolated. Of these, 135 (63.7%) were E. coli, including 15 strains (11.1%) that were
levofloxacin resistant. One hundred twenty-three patients (63.7%) were treated with
cephalosporin, and 46 patients (26.6%) were treated with
fluoroquinolone. In all, 140 patients (80.9%) visited the outpatient clinic for an average of 8.4 days after their treatment. For 130 patients (92.6%), the clinical outcomes of antimicrobial treatment were judged as effective. The clinical outcomes were effective in 92.1% of the patients with
cephalosporin treatment and in 97.1% of those with
fluoroquinolone treatment. Only one patient who had
levofloxacin-resistant E. coli in her urine was treated with
fluoroquinolone. The clinical outcome was effective. Of the E. coli isolated from acute uncomplicated
cystitis patients, 11.1% were
levofloxacin-resistant strains. However, the clinical efficacy of antimicrobial treatment was relatively high (92.9%) in this study. The antimicrobial treatment for acute uncomplicated
cystitis recommended by the guidelines published by the JAID and JSC was effective in the current situation.