Urinary tract infection (UTI) is common, especially in women, and the microbiology of UTI is predictable. Over the past decade, numerous reports have documented increasing resistance among uropathogens to first-line agents for the treatment of UTI, especially trimethoprim/sulfamethoxazole (TMP/SMX). It is recommended that TMP/SMX should not be administered as empiric therapy for UTI in communities where resistance rates exceed 20%. However, reliable data regarding the true prevalence of resistance in a community are often lacking. Preliminary work has suggested that recent antimicrobial use is an important risk factor for infection with a TMP/SMX-resistant isolate. A better understanding of the epidemiology of resistance is needed to aid therapeutic decisions and devise interventions to reduce or slow emerging resistance.
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