{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T04:13:39Z","timestamp":1745554419435,"version":"3.40.4"},"reference-count":0,"publisher":"S. Karger AG","issue":"6","license":[{"start":{"date-parts":[[1998,1,1]],"date-time":"1998-01-01T00:00:00Z","timestamp":883612800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[1998,1,1]],"date-time":"1998-01-01T00:00:00Z","timestamp":883612800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Chemotherapy"],"published-print":{"date-parts":[[1998]]},"abstract":"<jats:p>Recent Canadian, American and European studies have reported increased ampicillin and trimethoprim\/sulfamethoxazole resistance among urinary tract isolates of &lt;i&gt;Escherichia coli&lt;\/i&gt;. This trend suggests that a reevaluation of first- and second-line therapies for the treatment of community-acquired urinary tract infections is necessary. Mecillinam, a \u03b2-lactam with preferential activity against gram-negative penicillin binding protein 2 (unlike other \u03b2-lactams which preferentially bind gram-negative penicillin binding proteins 1a, 1b or 3), may offer clinically significant activity against ampicillin-resistant and trimethoprim\/sulfamethoxazole-resistant &lt;i&gt;E. coli&lt;\/i&gt;. To test this assertion, the activity of mecillinam was compared with ampicillin, trimethoprim\/sulfamethoxazole, nitrofurantoin and ciprofloxacin against 258 consecutive gram-negative urinary tract isolates collected at a Canadian tertiary care hospital. Mecillinam demonstrated significantly better activity than ampicillin and trimethoprim\/sulfamethoxazole and significantly less activity than ciprofloxacin and nitrofurantoin against the 258 isolates tested. Against &lt;i&gt;E. coli&lt;\/i&gt; isolates specifically, mecillinam was significantly more active than ampicillin and trimethoprim\/sulfamethoxazole (p &lt; 0.001) and as active as ciprofloxacin and nitrofurantoin. Mecillinam was active against 91.9% of ampicillin-resistant &lt;i&gt;E. coli&lt;\/i&gt; and 95.9% of trimethoprim\/sulfamethoxazole-resistant &lt;i&gt;E. coli&lt;\/i&gt;. We conclude that mecillinam should be reevaluated for potential use in the treatment of community-acquired urinary tract infections.<\/jats:p>","DOI":"10.1159\/000007149","type":"journal-article","created":{"date-parts":[[2003,4,15]],"date-time":"2003-04-15T15:42:49Z","timestamp":1050421369000},"page":"391-396","source":"Crossref","is-referenced-by-count":5,"title":["Mecillinam Activity Compared to Ampicillin, Trimethoprim\/Sulfamethoxazole, Ciprofloxacin and  Nitrofurantoin against Urinary Tract Isolates of Gram-Negative Bacilli"],"prefix":"10.1159","volume":"44","author":[{"given":"George G.","family":"Zhanel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James A.","family":"Karlowsky","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Schwartz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Signe Birk","family":"Jensen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daryl J.","family":"Hoban","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[1998,10,15]]},"container-title":["Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/7149","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/7149","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T04:38:21Z","timestamp":1745469501000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000007149"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998]]},"references-count":0,"journal-issue":{"issue":"6","published-online":{"date-parts":[[1998,12,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000007149","archive":["Portico"],"relation":{},"ISSN":["0009-3157","1421-9794"],"issn-type":[{"type":"print","value":"0009-3157"},{"type":"electronic","value":"1421-9794"}],"subject":[],"published":{"date-parts":[[1998]]}}}