Unmet Needs in Complicated Urinary Tract Infections: Challenges, Recommendations, and Emerging Treatment Pathways

References

• Wagenlehner FME, Bjerklund Johansen TE, Cai T, et al. Epidemiology, definition and treatment of complicated urinary tract infections. Nat Rev Urol. 2020;17(10):586–600. doi:10.1038/s41585-020-0362-4
   PubMed Web of Science ®Google Scholar
• Simmering JE, Tang F, Cavanaugh JE, Polgreen LA, Polgreen PM. The increase in hospitalizations for urinary tract infections and the associated costs in the United States, 1998–2011. Open Forum Infect Dis. 2017;4(1):ofw281. doi:10.1093/ofid/ofw281
   PubMed Web of Science ®Google Scholar
• Zilberberg MD, Nathanson BH, Sulham K, Shorr AF. Descriptive epidemiology and outcomes of hospitalizations with complicated urinary tract infections in the United States, 2018. Open Forum Infect Dis. 2022;9(1):ofab591. doi:10.1093/ofid/ofab591
   PubMed Web of Science ®Google Scholar
• Tackling drug-resistant infections globally: final report and recommendations / the review on antimicrobial resistance chaired by Jim O’Neill. Wellcome Collection. Available from: https://wellcomecollection.org/works/thvwsuba. Accessed September 18, 2022.
   Google Scholar
• Smith R, Coast J. The true cost of antimicrobial resistance. BMJ. 2013;346:f1493. doi:10.1136/bmj.f1493
   PubMed Web of Science ®Google Scholar
• Anger J, Lee U, Ackerman AL, et al. Recurrent uncomplicated urinary tract infections in women: AUA/CUA/SUFU guideline. J Urol. 2019;202(2):282–289. doi:10.1097/JU.0000000000000296
   PubMed Web of Science ®Google Scholar
• Johansen TEB, Botto H, Cek M, et al. Critical review of current definitions of urinary tract infections and proposal of an EAU/ESIU classification system. Int J Antimicrob Agents. 2011;38:64–70. doi:10.1016/j.ijantimicag.2011.09.009
   PubMed Web of Science ®Google Scholar
• US Food and Drug Administration. Complicated urinary tract infections: developing drugs for treatment; 2020. Available from: https://www.fda.gov/regulatory-information/search-fda-guidance-documents/complicated-urinary-tract-infections-developing-drugs-treatment. Accessed September 18, 2022.
   Google Scholar
• EMA. Evaluation of medicinal products indicated for treatment bacterial infections - scientific guideline. European Medicines Agency; 2018. Available from: https://www.ema.europa.eu/en/evaluation-medicinal-products-indicated-treatment-bacterial-infections-scientific-guideline. Accessed November 11, 2022.
   Google Scholar
• Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015;13(5):269–284. doi:10.1038/nrmicro3432
   PubMed Web of Science ®Google Scholar
• Zilberberg MD, Nathanson BH, Sulham K, Fan W, Shorr AF. Development and validation of a bedside instrument to predict carbapenem resistance among gram-negative pathogens in complicated urinary tract infections. Infect Control Hosp Epidemiol. 2018;39(9):1112–1114. doi:10.1017/ice.2018.166
   PubMed Web of Science ®Google Scholar
• Zowawi HM, Harris PNA, Roberts MJ, et al. The emerging threat of multidrug-resistant gram-negative bacteria in urology. Nat Rev Urol. 2015;12(10):570–584. doi:10.1038/nrurol.2015.199
   PubMed Web of Science ®Google Scholar
• Gomila A, Shaw E, Carratalà J, et al. Predictive factors for multidrug-resistant gram-negative bacteria among hospitalised patients with complicated urinary tract infections. Antimicrob Resist Infect Control. 2018;7(1):111. doi:10.1186/s13756-018-0401-6
   PubMedGoogle Scholar
• Tandoğdu Z, Bartoletti R, Cai T, et al. Antimicrobial resistance in urosepsis: outcomes from the multinational, multicenter global prevalence of infections in urology (GPIU) study 2003–2013. World J Urol. 2016;34(8):1193–1200. doi:10.1007/s00345-015-1722-1
   PubMed Web of Science ®Google Scholar
• Fleming-Dutra KE, Hersh AL, Shapiro DJ, et al. Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010–2011. JAMA. 2016;315(17):1864–1873. doi:10.1001/jama.2016.4151
   PubMed Web of Science ®Google Scholar
• Langner JL, Chiang KF, Stafford RS. Current prescribing practices and guideline concordance for the treatment of uncomplicated urinary tract infections in women. Am J Obstet Gynecol. 2021;225(3):272.e1–272.e11. doi:10.1016/j.ajog.2021.04.218
   PubMed Web of Science ®Google Scholar
• Mohareb AM, Letourneau AR, Sánchez SM, Walensky RP, Hyle EP. Addressing antibiotic overuse in the outpatient setting: lessons from behavioral economics. Mayo Clin Proc. 2021;96(3):537–542. doi:10.1016/j.mayocp.2020.10.033
   PubMed Web of Science ®Google Scholar
• Daniel M, Keller S, Mozafarihashjin M, Pahwa A, Soong C. An implementation guide to reducing overtreatment of asymptomatic bacteriuria. JAMA Intern Med. 2018;178(2):271–276. doi:10.1001/jamainternmed.2017.7290
   PubMed Web of Science ®Google Scholar
• Bonnal C, Baune B, Mion M, et al. Bacteriuria in a geriatric hospital: impact of an antibiotic improvement program. J Am Med Dir Assoc. 2008;9(8):605–609. doi:10.1016/j.jamda.2008.04.004
   PubMed Web of Science ®Google Scholar
• Renwick MJ, Simpkin V, Mossialos E. Targeting innovation in antibiotic drug discovery and development: the need for a one health – one Europe – one world framework. European Observatory on Health Systems and Policies; 2016. Available from: http://www.ncbi.nlm.nih.gov/books/NBK447337/. Accessed September 18, 2022.
   Google Scholar
• Flores-Mireles A, Hreha TN, Hunstad DA. Pathophysiology, treatment, and prevention of catheter-associated urinary tract infection. Top Spinal Cord Inj Rehabil. 2019;25(3):228–240. doi:10.1310/sci2503-228
   PubMed Web of Science ®Google Scholar
• Werneburg GT, Nguyen A, Henderson NS, et al. The natural history and composition of urinary catheter biofilms: early uropathogen colonization with intraluminal and distal predominance. J Urol. 2020;203(2):357–364. doi:10.1097/JU.0000000000000492
   PubMed Web of Science ®Google Scholar
• Hooton TM, Bradley SF, Cardenas DD, et al. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 international clinical practice guidelines from the infectious diseases society of America. Clin Infect Dis. 2010;50(5):625–663. doi:10.1086/650482
   PubMed Web of Science ®Google Scholar
• Loeb M, Bentley DW, Bradley S, et al. Development of minimum criteria for the initiation of antibiotics in residents of long-term–care facilities: results of a consensus conference. Infect Control Hosp Epidemiol. 2001;22(2):120–124. doi:10.1086/501875
   PubMed Web of Science ®Google Scholar
• Trautner BW, Petersen NJ, Hysong SJ, Horwitz D, Kelly PA, Naik AD. Overtreatment of asymptomatic bacteriuria: identifying provider barriers to evidence-based care. Am J Infect Control. 2014;42(6):653–658. doi:10.1016/j.ajic.2014.02.003
   PubMed Web of Science ®Google Scholar
• Zabarsky TF, Sethi AK, Donskey CJ. Sustained reduction in inappropriate treatment of asymptomatic bacteriuria in a long-term care facility through an educational intervention. Am J Infect Control. 2008;36(7):476–480. doi:10.1016/j.ajic.2007.11.007
   PubMed Web of Science ®Google Scholar
• Morton SC, Shekelle PG, Adams JL, et al. Antimicrobial prophylaxis for urinary tract infection in persons with spinal cord dysfunction. Arch Phys Med Rehabil. 2002;83(1):129–138. doi:10.1053/apmr.2002.26605
   PubMed Web of Science ®Google Scholar
• Lo E, Nicolle LE, Coffin SE, et al. Strategies to prevent catheter-associated urinary tract infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35(5):464–479. doi:10.1086/675718
   PubMed Web of Science ®Google Scholar
• Hoberman A, Greenfield SP, et al; RIVUR Trial Investigators. Antimicrobial prophylaxis for children with vesicoureteral reflux. N Engl J Med. 2014;370(25):2367–2376. doi:10.1056/NEJMoa1401811
   PubMed Web of Science ®Google Scholar
• Tandogdu Z, Cai T, Koves B, Wagenlehner F, Bjerklund-Johansen TE. Urinary tract infections in immunocompromised patients with diabetes, chronic kidney disease, and kidney transplant. Eur Urol Focus. 2016;2(4):394–399. doi:10.1016/j.euf.2016.08.006
   PubMedGoogle Scholar
• Geerlings SE, Meiland R, Hoepelman AIM. Pathogenesis of bacteriuria in women with diabetes mellitus. Int J Antimicrob Agents. 2002;19(6):539–545. doi:10.1016/s0924-8579(02)00090-0
   PubMed Web of Science ®Google Scholar
• Venmans LMAJ, Sloof M, Hak E, Gorter KJ, Rutten GEHM. Prediction of complicated urinary tract infections in patients with type 2 diabetes: a questionnaire study in primary care. Eur J Epidemiol. 2007;22(1):49. doi:10.1007/s10654-006-9077-y
   PubMed Web of Science ®Google Scholar
• van der Starre WE, Borgdorff H, Vollaard AM, et al. Diabetes and the course of febrile urinary tract infection. Diabetes Care. 2013;36(12):e193–e194. doi:10.2337/dc13-0903
   PubMed Web of Science ®Google Scholar
• Singh M, Sharma R, Kumar A. Safety of SGLT2 inhibitors in patients with diabetes mellitus. Curr Drug Saf. 2019;14(2):87–93. doi:10.2174/1574886314666190206164647
   PubMed Web of Science ®Google Scholar
• Chao CT, Lee SY, Wang J, Chien KL, Huang JW. Frailty increases the risk for developing urinary tract infection among 79,887 patients with diabetic mellitus and chronic kidney disease. BMC Geriatr. 2021;21(1):349. doi:10.1186/s12877-021-02299-3
   PubMed Web of Science ®Google Scholar
• Säemann M, Hörl WH. Urinary tract infection in renal transplant recipients. Eur J Clin Invest. 2008;38(Suppl 2):58–65. doi:10.1111/j.1365-2362.2008.02014.x
   PubMedGoogle Scholar
• Fiorentino M, Pesce F, Schena A, Simone S, Castellano G, Gesualdo L. Updates on urinary tract infections in kidney transplantation. J Nephrol. 2019;32(5):751–761. doi:10.1007/s40620-019-00585-3
   PubMed Web of Science ®Google Scholar
• Senger SS, Arslan H, Azap OK, Timurkaynak F, Cağir U, Haberal M. Urinary tract infections in renal transplant recipients. Transplant Proc. 2007;39(4):1016–1017. doi:10.1016/j.transproceed.2007.02.060
   PubMed Web of Science ®Google Scholar
• Abbott KC, Swanson SJ, Richter ER, et al. Late urinary tract infection after renal transplantation in the United States. Am J Kidney Dis. 2004;44(2):353–362. doi:10.1053/j.ajkd.2004.04.040
   PubMed Web of Science ®Google Scholar
• Pellé G, Vimont S, Levy PP, et al. Acute pyelonephritis represents a risk factor impairing long-term kidney graft function. Am J Transplant. 2007;7(4):899–907. doi:10.1111/j.1600-6143.2006.01700.x
   PubMed Web of Science ®Google Scholar
• El Amari EB, Hadaya K, Bühler L, et al. Outcome of treated and untreated asymptomatic bacteriuria in renal transplant recipients. Nephrol Dial Transplant. 2011;26(12):4109–4114. doi:10.1093/ndt/gfr198
   PubMed Web of Science ®Google Scholar
• Green H, Rahamimov R, Gafter U, Leibovitci L, Paul M. Antibiotic prophylaxis for urinary tract infections in renal transplant recipients: a systematic review and meta-analysis. Transpl Infect Dis. 2011;13(5):441–447. doi:10.1111/j.1399-3062.2011.00644.x
   PubMed Web of Science ®Google Scholar
• Ziakas PD, Pliakos EE, Zervou FN, Knoll BM, Rice LB, Mylonakis E. MRSA and VRE colonization in solid organ transplantation: a meta-analysis of published studies. Am J Transplant. 2014;14(8):1887–1894. doi:10.1111/ajt.12784
   PubMed Web of Science ®Google Scholar
• Köves B, Cai T, Veeratterapillay R, et al. Benefits and harms of treatment of asymptomatic bacteriuria: a systematic review and meta-analysis by the European Association of urology urological infection guidelines panel. Eur Urol. 2017;72(6):865–868. doi:10.1016/j.eururo.2017.07.014
   PubMed Web of Science ®Google Scholar
• Bookstaver PB, Bland CM, Griffin B, Stover KR, Eiland LS, McLaughlin M. A review of antibiotic use in pregnancy. Pharmacotherapy. 2015;35(11):1052–1062. doi:10.1002/phar.1649
   PubMed Web of Science ®Google Scholar
• López-Montesinos I, Horcajada JP. Oral and intravenous fosfomycin in complicated urinary tract infections. Rev Esp Quimioter. 2019;32(Suppl 1):37–44.
   PubMedGoogle Scholar
• Qiao LD, Zheng B, Chen S, et al. Evaluation of three-dose fosfomycin tromethamine in the treatment of patients with urinary tract infections: an uncontrolled, open-label, multicentre study. BMJ Open. 2013;3(12):e004157. doi:10.1136/bmjopen-2013-004157
   PubMed Web of Science ®Google Scholar
• Senol S, Tasbakan M, Pullukcu H, et al. Carbapenem versus fosfomycin tromethanol in the treatment of extended-spectrum beta-lactamase-producing Escherichia coli-related complicated lower urinary tract infection. J Chemother. 2010;22(5):355–357. doi:10.1179/joc.2010.22.5.355
   PubMed Web of Science ®Google Scholar
• Pullukcu H, Tasbakan M, Sipahi OR, Yamazhan T, Aydemir S, Ulusoy S. Fosfomycin in the treatment of extended spectrum beta-lactamase-producing Escherichia coli-related lower urinary tract infections. Int J Antimicrob Agents. 2007;29(1):62–65. doi:10.1016/j.ijantimicag.2006.08.039
   PubMed Web of Science ®Google Scholar
• Kaye KS, Rice LB, Dane AL, et al. Fosfomycin for injection (ZTI-01) versus piperacillin-tazobactam for the treatment of complicated urinary tract infection including acute pyelonephritis: ZEUS, a phase 2/3 randomized trial. Clin Infect Dis. 2019;69(12):2045–2056. doi:10.1093/cid/ciz181
   PubMed Web of Science ®Google Scholar
• NADAC (National Average Drug Acquisition Cost); 2022. Available from: https://data.medicaid.gov/dataset/dfa2ab14-06c2-457a-9e36-5cb6d80f8d93. Accessed November 14, 2022.
   Google Scholar
• Kassabian M, Calderwood MS, Ohsfeldt R. A cost-effectiveness analysis of fosfomycin: a single-dose antibiotic therapy for treatment of uncomplicated urinary tract infection. Health Serv Insights. 2022;15:11786329221126340. doi:10.1177/11786329221126340
   Web of Science ®Google Scholar
• Sadler S, Holmes M, Ren S, Holden S, Jha S, Thokala P. Cost-effectiveness of antibiotic treatment of uncomplicated urinary tract infection in women: a comparison of four antibiotics. BJGP Open. 2017;1(3). doi:10.3399/bjgpopen17X101097
   PubMedGoogle Scholar
• Ong A, Pietropaolo A, Brown G, Somani BK. Are intravesical aminoglycosides the new gold standard in the management of refractory urinary tract infection: a systematic review of literature. J Clin Med. 2022;11(19):5703. doi:10.3390/jcm11195703
   PubMed Web of Science ®Google Scholar
• Pietropaolo A, Jones P, Moors M, Birch B, Somani BK. Use and effectiveness of antimicrobial intravesical treatment for prophylaxis and treatment of recurrent Urinary Tract Infections (UTIs): a systematic review. Curr Urol Rep. 2018;19(10):78. doi:10.1007/s11934-018-0834-8
   PubMed Web of Science ®Google Scholar
• Cox L, He C, Bevins J, Clemens JQ, Stoffel JT, Cameron AP. Gentamicin bladder instillations decrease symptomatic urinary tract infections in neurogenic bladder patients on intermittent catheterization. Can Urol Assoc J. 2017;11(9):E350–E354. doi:10.5489/cuaj.4434
   PubMed Web of Science ®Google Scholar
• Andretta E, Longo R, Balladelli M, Sgarabotto C, Sgarabotto D. Intravesical gentamicin: an option for therapy and prophylaxis against recurrent UTIs and resistant bacteria in neurogenic bladder patients on intermittent catheterization. Antibiotics. 2022;11(10):1335. doi:10.3390/antibiotics11101335
   Google Scholar
• Cicione A, Cantiello F, Ucciero G, et al. Intravesical treatment with highly-concentrated hyaluronic acid and chondroitin sulphate in patients with recurrent urinary tract infections: results from a multicentre survey. Can Urol Assoc J. 2014;8(9–10):E721–E727. doi:10.5489/cuaj.1989
   PubMed Web of Science ®Google Scholar
• Wagenlehner FME, Tandogdu Z, Bjerklund Johansen TE. An update on classification and management of urosepsis. Curr Opin Urol. 2017;27(2):133–137. doi:10.1097/MOU.0000000000000364
   PubMed Web of Science ®Google Scholar
• Portsmouth S, Bass A, Echols R, Tillotson G. Heterogeneity of recent phase 3 complicated urinary tract infection clinical trials. Open Forum Infect Dis. 2021;8(3):ofab045. doi:10.1093/ofid/ofab045
   PubMed Web of Science ®Google Scholar
• Malaisri C, Phuphuakrat A, Wibulpolprasert A, Santanirand P, Kiertiburanakul S. A randomized controlled trial of sitafloxacin vs. ertapenem as a switch therapy after treatment for acute pyelonephritis caused by extended-spectrum β-lactamase-producing Escherichia coli: a pilot study. J Infect Chemother. 2017;23(8):556–562. doi:10.1016/j.jiac.2017.05.005
   PubMed Web of Science ®Google Scholar
• Seo YB, Lee J, Kim YK, et al. Randomized controlled trial of piperacillin-tazobactam, cefepime and ertapenem for the treatment of urinary tract infection caused by extended-spectrum beta-lactamase-producing Escherichia coli. BMC Infect Dis. 2017;17(1):404. doi:10.1186/s12879-017-2502-x
   PubMed Web of Science ®Google Scholar
• Kaye KS, Bhowmick T, Metallidis S, et al. Effect of meropenem-vaborbactam vs piperacillin-tazobactam on clinical cure or improvement and microbial eradication in complicated urinary tract infection: the TANGO I randomized clinical trial. JAMA. 2018;319(8):788–799. doi:10.1001/jama.2018.0438
   PubMed Web of Science ®Google Scholar
• Harris PNA, Tambyah PA, Lye DC, et al. Effect of piperacillin-tazobactam vs meropenem on 30-day mortality for patients with E coli or Klebsiella pneumoniae bloodstream infection and ceftriaxone resistance: a randomized clinical trial. JAMA. 2018;320(10):984–994. doi:10.1001/jama.2018.12163
   PubMed Web of Science ®Google Scholar
• Portsmouth S, Veenhuyzen D, Echols R, et al. Cefiderocol versus imipenem-cilastatin for the treatment of complicated urinary tract infections caused by gram-negative uropathogens: a phase 2, randomised, double-blind, non-inferiority trial. Lancet Infect Dis. 2018;18(12):1319–1328. doi:10.1016/S1473-3099(18)30554-1
   PubMed Web of Science ®Google Scholar
• Bassetti M, Echols R, Matsunaga Y, et al. Efficacy and safety of cefiderocol or best available therapy for the treatment of serious infections caused by carbapenem-resistant gram-negative bacteria (CREDIBLE-CR): a randomised, open-label, multicentre, pathogen-focused, descriptive, phase 3 trial. Lancet Infect Dis. 2021;21(2):226–240. doi:10.1016/S1473-3099(20)30796-9
   PubMed Web of Science ®Google Scholar
• The Joint Commission. New and revised requirements addressing antibiotic stewardship for the hospital and critical access hospital programs. Available from: https://www.jointcommission.org/standards/prepublication-standards/new-and-revised-requirements-addressing-antibiotic-stewardship-for-hospital/. Accessed September 19, 2022.
   Google Scholar
• XERAVA (eravacycline) for injection [package insert]. Tetraphase Pharm. Waltham, MA; 2018.
   Google Scholar
• GlobeNewswire News Room. Tetraphase announces top-line results from IGNITE3 phase 3 clinical trial of eravacycline in complicated Urinary Tract Infections (cUTI); 2018. Available from: https://www.globenewswire.com/news-release/2018/02/13/1340188/34757/en/Tetraphase-Announces-Top-Line-Results-from-IGNITE3-Phase-3-Clinical-Trial-of-Eravacycline-in-Complicated-Urinary-Tract-Infections-cUTI.html. Accessed November 14, 2022.
   Google Scholar
• Motsch J, Murta de Oliveira C, Stus V, et al. RESTORE-IMI 1: a multicenter, randomized, double-blind trial comparing efficacy and safety of imipenem/relebactam vs colistin plus imipenem in patients with imipenem-nonsusceptible bacterial infections. Clin Infect Dis. 2020;70(9):1799–1808. doi:10.1093/cid/ciz530
   PubMed Web of Science ®Google Scholar
• George Sakoulas MD. FDA approves imipenem-cilastatin/relebactam (recarbrio) for complicated intra-abdominal or urinary tract infections. NEJM J Watch. 2019;2019. doi:10.1056/nejm-jw.NA49571
   Google Scholar
• Wagenlehner FME, Cloutier DJ, Komirenko AS, et al. Once-daily plazomicin for complicated urinary tract infections. N Engl J Med. 2019;380(8):729–740. doi:10.1056/NEJMoa1801467
   PubMed Web of Science ®Google Scholar
• Inc A. ZEMDRITM (plazomicin) approved by FDA for the treatment of adults with complicated Urinary Tract Infections (cUTI). GlobeNewswire News Room; 2018. Available from: https://www.globenewswire.com/news-release/2018/06/26/1529573/30133/en/ZEMDRITM-plazomicin-Approved-by-FDA-for-the-Treatment-of-Adults-with-Complicated-Urinary-Tract-Infections-cUTI.html. Accessed December 2, 2022.
   Google Scholar
• Kaye KS, Belley A, Barth P, et al. Effect of cefepime/enmetazobactam vs piperacillin/tazobactam on clinical cure and microbiological eradication in patients with complicated urinary tract infection or acute pyelonephritis: a randomized clinical trial. JAMA. 2022;328(13):1304–1314. doi:10.1001/jama.2022.17034
   PubMed Web of Science ®Google Scholar
• Allecra therapeutics publishes final phase 3 ALLIUM data in JAMA: cefepime/enmetazobactam met criteria for superiority; 2022. Available from: https://www.businesswire.com/news/home/20221005005413/en/Allecra-Therapeutics-Publishes-Final-Phase-3-ALLIUM-Data-in-JAMA-CefepimeEnmetazobactam-Met-Criteria-for-Superiority. Accessed December 2, 2022.
   Google Scholar
• Eckburg PB, Muir L, Critchley IA, et al. Oral tebipenem pivoxil hydrobromide in complicated urinary tract infection. N Engl J Med. 2022;386(14):1327–1338. doi:10.1056/NEJMoa2105462
   PubMed Web of Science ®Google Scholar
• Duffy S. FDA needs more data on tebipenem HBr for complicated UTI. MPR; 2022. Available from: https://www.empr.com/home/news/drugs-in-the-pipeline/fda-needs-more-data-on-tebipenem-hbr-for-complicated-uti/. Accessed November 14, 2022.
   Google Scholar
• Rex JH, Eisenstein BI, Alder J, et al. A comprehensive regulatory framework to address the unmet need for new antibacterial treatments. Lancet Infect Dis. 2013;13(3):269–275. doi:10.1016/S1473-3099(12)70293-1
   PubMed Web of Science ®Google Scholar
• IMI Innovative Medicines Initiative. ND4BB | new drugs for bad bugs. IMI Innovative Medicines Initiative. Available from: http://www.imi.europa.eu/projects-results/project-factsheets/nd4bb. Accessed September 18, 2022.
   Google Scholar
• Gingrey P. H.R.2182-112th congress (2011–2012): generating antibiotic incentives now act of 2011; 2011. Available from: http://www.congress.gov/. Accessed September 18, 2022.
   Google Scholar
• FDA. Limited population pathway for antibacterial and antifungal drugs – the LPAD pathway; 2020. Available from: https://www.fda.gov/drugs/development-resources/limited-population-pathway-antibacterial-and-antifungal-drugs-lpad-pathway. Accessed November 14, 2022.
   Google Scholar
• Turner KM, Christensen H, Adams EJ, et al. Analysis of the potential for point-of-care test to enable individualised treatment of infections caused by antimicrobial-resistant and susceptible strains of Neisseria gonorrhoeae: a modelling study. BMJ Open. 2017;7(6):e015447. doi:10.1136/bmjopen-2016-015447
   PubMed Web of Science ®Google Scholar
• Wojno KJ, Baunoch D, Luke N, et al. Multiplex PCR based Urinary Tract Infection (UTI) analysis compared to traditional urine culture in identifying significant pathogens in symptomatic patients. Urology. 2020;136:119–126. doi:10.1016/j.urology.2019.10.018
   PubMedGoogle Scholar
• Elligsen M, Pinto R, Leis JA, Walker SAN, Daneman N, MacFadden DR. Improving Decision Making in Empiric Antibiotic Selection (IDEAS) for gram-negative bacteremia: a prospective clinical implementation study. Clin Infect Dis. 2021;73(2):e417–e425. doi:10.1093/cid/ciaa921
   PubMed Web of Science ®Google Scholar
• Gupta K, Hooton TM, Naber KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the infectious diseases society of America and the European society for microbiology and infectious diseases. Clin Infect Dis. 2011;52(5):e103–e120. doi:10.1093/cid/ciq257
   PubMed Web of Science ®Google Scholar
• Medical student curriculum: adult UTI - American Urological Association. Available from: https://www.auanet.org/meetings-and-education/for-medical-students/medical-students-curriculum/adult-uti. Accessed December 1, 2022.
   Google Scholar
• Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group. KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant. 2009;9(Suppl 3):S1–S155. doi:10.1111/j.1600-6143.2009.02834.x
   PubMed Web of Science ®Google Scholar
• Al Midani A, Elands S, Collier S, Harber M, Shendi AM. Impact of urinary tract infections in kidney transplant recipients: a 4-year single-center experience. Transplant Proc. 2018;50(10):3351–3355. doi:10.1016/j.transproceed.2018.08.022
   PubMed Web of Science ®Google Scholar
• VABOMERE (meropenem and vaborbactam) for injection [package insert]. Melinta Ther. Parisppany New Jersey; 2017.
   Google Scholar
• FDA. FDA approves new antibacterial drug to treat complicated urinary tract infections as part of ongoing efforts to address antimicrobial resistance; 2020. Available from: https://www.fda.gov/news-events/press-announcements/fda-approves-new-antibacterial-drug-treat-complicated-urinary-tract-infections-part-ongoing-efforts. Accessed December 2, 2022.
   Google Scholar