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Related Concept Videos

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

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A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
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Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Urine Studies II: Urine Culture and Sensitivity Test01:26

Urine Studies II: Urine Culture and Sensitivity Test

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A urine culture and sensitivity test is a diagnostic procedure used to identify urinary tract bacterial infections and determine the most effective antibiotics for treatment. This test is generally preferred when a patient shows manifestations of a urinary tract infection, such as frequent or painful urination, cloudy or foul-smelling urine, or lower abdominal pain.Purpose of the TestThe primary goals of a urine culture and sensitivity test are to:Determine the specific bacteria causing the...
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Estimation of k and VD of Aminoglycosides01:20

Estimation of k and VD of Aminoglycosides

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Aminoglycosides are a class of antibiotics used to treat various bacterial infections. Clinicians must determine the elimination rate constant (k) and volume of distribution (VD) to optimize therapeutic efficacy and minimize toxicity. The k value represents the rate at which the drug is removed from the body, and the VD reflects the degree to which the drug distributes into body tissues. Accurately estimating these parameters allows healthcare professionals to tailor drug dosing to individual...
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Combined Effects of Drugs: Synergism01:27

Combined Effects of Drugs: Synergism

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Synergism is a useful mechanism where combining two or more drugs is more effective than each constituent used alone. Such combinations are also called supra-additive interactions. The drugs collectively enhance the final therapeutic effect by acting on different targets. Another advantage is that the low dose of each constituent drug is sufficient to achieve the desired effect. This helps reduce the duration of therapy and lower the adverse effects of these drugs.
Such synergistic combinations...
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Development of Antibiotic Resistance01:30

Development of Antibiotic Resistance

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Antibiotic resistance is a major public health concern that arises when bacteria evolve mechanisms to withstand the effects of antibiotic treatments. This resistance can be intrinsic, acquired through genetic mutations, or transferred between bacteria via horizontal gene transfer. The development of antibiotic resistance poses significant challenges in treating bacterial infections and necessitates ongoing research to develop new therapeutic strategies.Intrinsic resistance occurs when bacterial...
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Related Experiment Video

Updated: Jan 14, 2026

An In Vitro Bladder Model of Catheter-Associated Urinary Tract Infection
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Do Aminopenicillins Have a Role in Treating Ampicillin-Resistant Enterococcus UTIs?

Armani M Hawes1, Pranita D Tamma2, Navaneeth Narayanan3,4

  • 1Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Open Forum Infectious Diseases
|October 20, 2025
PubMed
Summary

Aminopenicillins may remain effective for treating urinary tract infections caused by ampicillin-resistant Enterococcus species. This review integrates data to assess their continued viability in clinical practice.

Keywords:
aminopenicillinsantimicrobial resistancebacterial infectionspharmacokinetics/pharmacodynamicsurinary tract infections

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Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Clinical Microbiology

Background:

  • Urinary tract infections (UTIs) caused by Enterococcus species present a significant clinical challenge.
  • Increasing ampicillin resistance in Enterococcus strains often leads to the exclusion of aminopenicillins from treatment regimens.

Purpose of the Study:

  • To evaluate the potential clinical utility of aminopenicillins for treating ampicillin-resistant Enterococcus infections.
  • To integrate pharmacokinetic/pharmacodynamic (PK/PD) data, clinical evidence, and risk-benefit analyses.

Main Methods:

  • Review of existing pharmacokinetic/pharmacodynamic (PK/PD) data.
  • Analysis of clinical studies and case reports.
  • Assessment of risk-benefit profiles for aminopenicillin use.

Main Results:

  • Emerging evidence suggests that aminopenicillins may retain clinical efficacy despite in vitro resistance.
  • PK/PD parameters and clinical outcomes indicate a potential for successful treatment in select cases.

Conclusions:

  • Aminopenicillins could still be a viable therapeutic option for ampicillin-resistant Enterococcus UTIs.
  • Further clinical studies are warranted to define optimal usage and patient selection criteria.