Oral β‐Lactams for Complicated Urinary Tract Infections: A Systematic Review and Point‐Counterpoint Comparison With Trimethoprim/Sulfamethoxazole and Fluoroquinolones

Although not traditionally recognized as first-line therapy, select oral β-lactams demonstrated effectiveness comparable to FQs or TMP/SMX for cUTIs and bacteremic UTI and can serve as effective alternatives in appropriately selected patients. When optimally dosed, these β-lactams achieve comparable outcomes with favorable safety profiles and antimicrobial stewardship advantages. Randomized trials are needed to confirm these observational findings and to better define optimal dosing strategies and shorter treatment durations.

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Publication Details

Journal
Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy
Published
2026-02-15
DOI
https://doi.org/10.1002/phar.70118
Primary Topic
Urinary Tract Infections Management
Type
article
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article

Oral β‐Lactams for Complicated Urinary Tract Infections: A Systematic Review and Point‐Counterpoint Comparison With Trimethoprim/Sulfamethoxazole and Fluoroquinolones

Kinsey M. Johannemann, Elizabeth W. Covington, Amy Kang, Grant Stimes et al.
Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy
Urinary Tract Infections Management
article

Oral β‐Lactams for Complicated Urinary Tract Infections: A Systematic Review and Point‐Counterpoint Comparison With Trimethoprim/Sulfamethoxazole and Fluoroquinolones

Kinsey M. Johannemann, Elizabeth W. Covington, Amy Kang, Grant Stimes, Colter G. Sheveland, Ashlan J. Kunz Coyne, James E. Sanders, Spencer H. Durham, Trang D Trinh, Kevin Nguyen, Jeannette Bouchard, W. Justin Moore
article en

Abstract

Although not traditionally recognized as first-line therapy, select oral β-lactams demonstrated effectiveness comparable to FQs or TMP/SMX for cUTIs and bacteremic UTI and can serve as effective alternatives in appropriately selected patients. When optimally dosed, these β-lactams achieve comparable outcomes with favorable safety profiles and antimicrobial stewardship advantages. Randomized trials are needed to confirm these observational findings and to better define optimal dosing strategies and shorter treatment durations.

Pharmacotherapy The Journal of Human Pharmacology and Drug TherapyVol. 46(3)
Huntsville Hospital (US), University of Kentucky (US), Duke University (US), University of California, San Francisco (US), Chapman University (US), Palmetto Health Richland (US), Southwestern Medical Center (US), Northwestern Medicine (US), Texas Children's Hospital (US), St. Christopher's Hospital for Children (US), University of San Francisco (US), Auburn University (US), The University of Texas Southwestern Medical Center (US)
Openalex Percentile: Top 53%
Urinary Tract Infections Management
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