Urinary Tract Infections Caused by <i>Klebsiella pneumoniae</i> and Prolonged Treatment with Trimethoprim/Sulfamethoxazole

Urinary tract infections (UTIs) are among the most prevalent bacterial infections, with <i>Klebsiella pneumoniae</i> emerging as a significant multidrug-resistant pathogen, particularly in healthcare settings. The frequent utilization of β-lactams and fluoroquinolones has contributed to...

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Main Authors: Rumen Filev, Mila Lyubomirova, Boris Bogov, Alexander Kolevski, Victoria Pencheva, Krasimir Kalinov, Lionel Rostaing
Format: Article
Language:English
Published: MDPI AG 2025-02-01
Series:Microorganisms
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Online Access:https://www.mdpi.com/2076-2607/13/2/422
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author Rumen Filev
Mila Lyubomirova
Boris Bogov
Alexander Kolevski
Victoria Pencheva
Krasimir Kalinov
Lionel Rostaing
author_facet Rumen Filev
Mila Lyubomirova
Boris Bogov
Alexander Kolevski
Victoria Pencheva
Krasimir Kalinov
Lionel Rostaing
author_sort Rumen Filev
collection DOAJ
description Urinary tract infections (UTIs) are among the most prevalent bacterial infections, with <i>Klebsiella pneumoniae</i> emerging as a significant multidrug-resistant pathogen, particularly in healthcare settings. The frequent utilization of β-lactams and fluoroquinolones has contributed to the reduced clinical application of trimethoprim-sulfamethoxazole (TRS). Nevertheless, this reduced use may have preserved its efficacy as a second-line therapy. The aim of this study is to determine whether TRS can be a cost-effective long-term solution for patients with multidrug-resistant <i>K. pneumoniae</i> UTIs. This study evaluated the effectiveness of a structured, long-term TRS regimen in 11 patients with recurrent <i>K. pneumoniae</i> UTIs who had failed at least two prior antibiotic treatments. Patients were carefully selected, and the collected data were analyzed using descriptive analysis. The findings demonstrated microbiological eradication and symptomatic relief in all patients, with only one case of a delayed allergic reaction. All patients had a negative urine microbiology analysis after at least two unsuccessful treatment attempts over a period of 6 to 18 months. These results underscore TRS’s potential as a cost-effective and efficient second-line treatment, particularly in settings with limited therapeutic options. Its affordability, manageable side effect profile, and ability to target biofilm-associated infections further highlight its therapeutic value.
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spelling doaj-art-0352c5f4345f4e4a9eefc20a3290d60c2025-08-20T03:11:21ZengMDPI AGMicroorganisms2076-26072025-02-0113242210.3390/microorganisms13020422Urinary Tract Infections Caused by <i>Klebsiella pneumoniae</i> and Prolonged Treatment with Trimethoprim/SulfamethoxazoleRumen Filev0Mila Lyubomirova1Boris Bogov2Alexander Kolevski3Victoria Pencheva4Krasimir Kalinov5Lionel Rostaing6Department of Nephrology, Internal Disease Clinic, University Hospital “Saint Anna”, 1750 Sofia, BulgariaDepartment of Nephrology, Internal Disease Clinic, University Hospital “Saint Anna”, 1750 Sofia, BulgariaDepartment of Nephrology, Internal Disease Clinic, University Hospital “Saint Anna”, 1750 Sofia, BulgariaDepartment of Microbiology, University Hospital “Alexandrovska”, 1431 Sofia, BulgariaDepartment of Microbiology, University Hospital “Alexandrovska”, 1431 Sofia, BulgariaComac-Medical Ltd., 1404 Sofia, BulgariaNephrology, Hemodialysis, Apheresis and Kidney Transplantation Department, Grenoble University Hospital, 38043 Grenoble, FranceUrinary tract infections (UTIs) are among the most prevalent bacterial infections, with <i>Klebsiella pneumoniae</i> emerging as a significant multidrug-resistant pathogen, particularly in healthcare settings. The frequent utilization of β-lactams and fluoroquinolones has contributed to the reduced clinical application of trimethoprim-sulfamethoxazole (TRS). Nevertheless, this reduced use may have preserved its efficacy as a second-line therapy. The aim of this study is to determine whether TRS can be a cost-effective long-term solution for patients with multidrug-resistant <i>K. pneumoniae</i> UTIs. This study evaluated the effectiveness of a structured, long-term TRS regimen in 11 patients with recurrent <i>K. pneumoniae</i> UTIs who had failed at least two prior antibiotic treatments. Patients were carefully selected, and the collected data were analyzed using descriptive analysis. The findings demonstrated microbiological eradication and symptomatic relief in all patients, with only one case of a delayed allergic reaction. All patients had a negative urine microbiology analysis after at least two unsuccessful treatment attempts over a period of 6 to 18 months. These results underscore TRS’s potential as a cost-effective and efficient second-line treatment, particularly in settings with limited therapeutic options. Its affordability, manageable side effect profile, and ability to target biofilm-associated infections further highlight its therapeutic value.https://www.mdpi.com/2076-2607/13/2/422urinary tractinfection<i>Klebsiella pneumonia</i>trimethoprim/sulfamethoxazole
spellingShingle Rumen Filev
Mila Lyubomirova
Boris Bogov
Alexander Kolevski
Victoria Pencheva
Krasimir Kalinov
Lionel Rostaing
Urinary Tract Infections Caused by <i>Klebsiella pneumoniae</i> and Prolonged Treatment with Trimethoprim/Sulfamethoxazole
Microorganisms
urinary tract
infection
<i>Klebsiella pneumonia</i>
trimethoprim/sulfamethoxazole
title Urinary Tract Infections Caused by <i>Klebsiella pneumoniae</i> and Prolonged Treatment with Trimethoprim/Sulfamethoxazole
title_full Urinary Tract Infections Caused by <i>Klebsiella pneumoniae</i> and Prolonged Treatment with Trimethoprim/Sulfamethoxazole
title_fullStr Urinary Tract Infections Caused by <i>Klebsiella pneumoniae</i> and Prolonged Treatment with Trimethoprim/Sulfamethoxazole
title_full_unstemmed Urinary Tract Infections Caused by <i>Klebsiella pneumoniae</i> and Prolonged Treatment with Trimethoprim/Sulfamethoxazole
title_short Urinary Tract Infections Caused by <i>Klebsiella pneumoniae</i> and Prolonged Treatment with Trimethoprim/Sulfamethoxazole
title_sort urinary tract infections caused by i klebsiella pneumoniae i and prolonged treatment with trimethoprim sulfamethoxazole
topic urinary tract
infection
<i>Klebsiella pneumonia</i>
trimethoprim/sulfamethoxazole
url https://www.mdpi.com/2076-2607/13/2/422
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