Fluoroquinolone Resistance in UTI – Is It Time to Change Drugs?

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Fluoroquinolone-resistant (FQR) E. coli was present in 22.1% of UTI pathogens studied at 15 geographically diverse EDs. IDSA guidelines recommend changing empiric treatment if local resistance is >10% and adding a dose of parenteral antibiotic, such as ceftriaxone, prior to discharge home.

High prevalence of fluoroquinolone-resistant UTI among US emergency department patients diagnosed with urinary tract infection, 2018-2020. Acad Emerg Med. 2022 Sep;29(9):1096-1105. doi: 10.1111/acem.14545. Epub 2022 Aug 5.

CT with Contrast for Kidney Stones?

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Contrast-enhanced CT has a very high negative predictive value (100%) for obstructive urolithiasis and appears to accurately and safely exclude obstructing ureteral calculi for patients with acute flank pain. In addition, IV contrast improves the diagnostic yield for other acute abdominopelvic pathology and perhaps should be the test of choice for patients presenting with acute flank pain.

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