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Within the penicillin class, pivmecillinam is considered the first-line empiric treatment for acute cystitis due to its wide spectrum of activity against gram-negative bacteria and its specific efficacy in the urinary tract. It has consistently demonstrated a high cure rate of over 85% for UTIs and a low resistance rate among E. coli strains.
E. coli can invade the superficial umbrella cells of the bladder to form intracellular bacterial communities (IBCs), which can mature into biofilms. These biofilm-producing E. coli are resistant to antibiotic therapy and immune system responses, and present a possible explanation for recurrent urinary tract infections, including pyelonephritis ...
A urinary tract infection (UTI) is an infection that affects a part of the urinary tract. [1] Lower urinary tract infections may involve the bladder ( cystitis ) or urethra ( urethritis ) while upper urinary tract infections affect the kidney ( pyelonephritis ). [ 10 ]
Nitrofurantoin, sold under the brand name Macrobid among others, is an antibacterial medication of the nitrofuran class used to treat urinary tract infections (UTIs), although it is not as effective for kidney infections. [16] It is taken by mouth. [16] Common side effects include nausea, loss of appetite, diarrhea, and headaches. [16]
Adherence to host uroepithelial cells is a crucial step during the infection that allows uropathogenic E.coli to colonize the urinary tract and prevents bacterial removal during micturition. The binding of the P fimbriae to epithelial cells is mediated by the tip adhesin PapG.
Most E. coli strains do not cause disease, naturally living in the gut, [83] but virulent strains can cause gastroenteritis, urinary tract infections, neonatal meningitis, hemorrhagic colitis, and Crohn's disease. [84] Common signs and symptoms include severe abdominal cramps, diarrhea, hemorrhagic colitis, vomiting, and sometimes fever.