Current and emerging strategies to curb antibiotic-resistant urinary tract infections

Nat Rev Urol. 2024 Dec;21(12):707-722. doi: 10.1038/s41585-024-00877-9. Epub 2024 May 7.

Abstract

Rising rates of antibiotic resistance in uropathogenic bacteria compromise patient outcomes and prolong hospital stays. Consequently, new strategies are needed to prevent and control the spread of antibiotic resistance in uropathogenic bacteria. Over the past two decades, sizeable clinical efforts and research advances have changed urinary tract infection (UTI) treatment and prevention strategies to conserve antibiotic use. The emergence of antimicrobial stewardship, policies from national societies, and the development of new antimicrobials have shaped modern UTI practices. Future UTI management practices could be driven by the evolution of antimicrobial stewardship, improved and readily available diagnostics, and an improved understanding of how the microbiome affects UTI. Forthcoming UTI treatment and prevention strategies could employ novel bactericidal compounds, combinations of new and classic antimicrobials that enhance bacterial killing, medications that prevent bacterial attachment to uroepithelial cells, repurposing drugs, and vaccines to curtail the rising rates of antibiotic resistance in uropathogenic bacteria and improve outcomes in people with UTI.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Anti-Bacterial Agents* / therapeutic use
  • Antimicrobial Stewardship
  • Drug Resistance, Bacterial
  • Humans
  • Urinary Tract Infections* / drug therapy
  • Urinary Tract Infections* / microbiology
  • Urinary Tract Infections* / prevention & control

Substances

  • Anti-Bacterial Agents