Fluoroquinolone Resistance Among Gram-Negative Urinary Tract Pathogens: Global Smart Program Results, 2009-2010

Sam Bouchillon 1, *, Daryl J Hoban 1, Robert Badal 1, Stephen Hawser 2
1 International Health Management Associates, Inc., Schaumburg, IL, 60178 USA
2 IHMA Europe Sàrl, Rote de la Corniche 4, 1066 Epalinges, Switzerland

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© Bouchillon et al.; Licensee Bentham Open.

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* Address correspondence to this author at the International Health Management Associates, Inc. 2122 Palmer Drive, Schaumburg, IL 60173 USA; Tel: +1 615.599.8429; Fax: +1 847.303.5601; E-mail:



To determine the rates of fluoroquinolone resistant (FQR) in gram-negative bacilli urinary tract infections (UTIs) in a global population.


The Study for Monitoring Antimicrobial Resistance Trends (SMART) collected 1,116 FQR gram-negative urinary pathogens from hospitalized patients in 33 countries during 2009-2010. Amikacin, ertapenem, and imipenem were the most active agents tested against FQR UTI pathogens, including extended-spectrum beta-lactamase producers.


FQR rates vary widely country to country with a range of 6% to 75%. Regional FQR rates were 23.5% in North America, 29.4% in Europe, 33.2% in Asia, 38.7% in Latin America, and 25.5% in the South Pacific.


These observations suggest that fluoroquinolones may no longer be effective as first-line therapy for gram-negative UTI in hospitalized patients.

Keywords: Ertapenem, Fluoroquinolone resistance, Imipenem, SMART Global Surveillance, Urinary Tract Infection.