Version 1
: Received: 17 January 2024 / Approved: 18 January 2024 / Online: 18 January 2024 (13:03:03 CET)
How to cite:
Tyagi, P.; Tyagi, S.; Stewart, L.; Glickman, S. SWOT and Root Cause Analysis of Antimicrobial Resistance to Oral Antimicrobial Treatment of Cystitis. Preprints2024, 2024011425. https://doi.org/10.20944/preprints202401.1425.v1
Tyagi, P.; Tyagi, S.; Stewart, L.; Glickman, S. SWOT and Root Cause Analysis of Antimicrobial Resistance to Oral Antimicrobial Treatment of Cystitis. Preprints 2024, 2024011425. https://doi.org/10.20944/preprints202401.1425.v1
Tyagi, P.; Tyagi, S.; Stewart, L.; Glickman, S. SWOT and Root Cause Analysis of Antimicrobial Resistance to Oral Antimicrobial Treatment of Cystitis. Preprints2024, 2024011425. https://doi.org/10.20944/preprints202401.1425.v1
APA Style
Tyagi, P., Tyagi, S., Stewart, L., & Glickman, S. (2024). SWOT and Root Cause Analysis of Antimicrobial Resistance to Oral Antimicrobial Treatment of Cystitis. Preprints. https://doi.org/10.20944/preprints202401.1425.v1
Chicago/Turabian Style
Tyagi, P., Laurence Stewart and Scott Glickman. 2024 "SWOT and Root Cause Analysis of Antimicrobial Resistance to Oral Antimicrobial Treatment of Cystitis" Preprints. https://doi.org/10.20944/preprints202401.1425.v1
Abstract
Out of a worldwide annual incidence of ~150 million cases for urinary tract infection (UTI), >25% of outpatient prescriptions of oral antimicrobial treatment (OAT) are for cystitis not complicated by sepsis. OAT aids the immune cells infiltrating urothelium to eliminate uropathogens attaching and invading urothelium amidst hyperosmotic urine. This adaptability of uropathogens and the short interval between Penicillin sale and the first antimicrobial resistance (AMR) report suggests that AMR is a 3.8 billion years old evolutionary conserved heritable trait of surviving environmental threats through exponential proliferation of mutant strains selected by Darwinian principle. Therefore, OAT success with minimal AMR can be ensured by antimicrobial stewardship (AMS) following the principle of 5Ds -drug, dose, duration, drug-route, and de-escalation. While convenient to administer, the onset of minimum inhibitory concentration (MIC) for OAT in urine is a window of opportunity for uropathogens to survive the first contact with OAT and the descendant colonies armed with AMR are likely to survive subsequent higher urine OAT levels. Meanwhile, intravesical antimicrobial treatment (IAT) delivers the first strike well above MIC. The root cause analysis of AMR dovetails with the strengths, weaknesses, opportunity, and threat (SWOT) analysis of OAT in this interdisciplinary review.
Keywords
UTI, AMR, oral treatment and intravesical treatment
Subject
Medicine and Pharmacology, Clinical Medicine
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
