COMPARATIVE IN-VITRO ACTIVITY OF CEFACLOR AGAINST URINARY-TRACT ISOLATES OF ESCHERICHIA-COLI

Insusceptibility levels of cefaclor and other commonly prescribed anti biotics were determined for 489 consecutive hospital and community-ass ociated urinary tract isolates of Escherichia coli from the Nottingham area of the UK. Significant resistance (MIC of greater than or equal to 8 mg/L) to cefaclor was found to be uncommon in the UK, with insusc eptibility percentages as low as 1.5% and 1.4% amongst hospital and co mmunity isolates, respectively. When compared with other antimicrobial s used commonly for treating urinary tract infection, only ciprofloxac in showed greater activity, though cefaclor showed significantly great er in-vitro activity than cephalexin, ampicillin and trimethoprim. Onl y seven isolates were insusceptible to cefaclor at a concentration of 8 mg/L. Each of these isolates produced a beta-lactamase, but it is un likely that beta-lactamase production was the sole reason for insuscep tibility since these isolates were also insusceptible to co-amoxiclav. Cefaclor compared extremely well with co-amoxiclav against ampicillin -insusceptible isolates, with none of the pharmacokinetic difficulties and considerations associated with the use of beta-lactam:beta-lactam ase inhibitor combinations. Cefaclor appears to be a useful cost-effec tive alternative to current therapeutic options, particularly for long -term low-dose treatment of recurrent urinary tract infection in those geographical areas where the likelihood of resistance to other possib le agents is becoming unacceptably high.