Résumé
Urinary tract infections (UTIs) are a common cause of emergency department visits. Although fluoroquinolones (FQs) are frequently used to treat enterococcal UTIs, their clinical efficacy is not well documented. This study compares the efficacy of FQs with that of amoxicillin in the treatment of enterococcal UTIs. Method: we carried out a retrospective multicenter study in the emergency departments in Nîmes, Montpellier, and Béziers hospitals between January 2020 and December 2022. Patients with monomicrobial enterococcal UTIs treated with either FQs or amoxicillin were included. The primary objective was to evaluate the clinical failure rate at 12 weeks after the initiation of treatment using a propensity score weighted analysis. Results: among 895 patients with enterococcal positive urine cultures, 83 were included: 33 treated with FQs and 50 with amoxicillin. Clinical cure at 12 weeks was similar between groups: 85% for FQs vs. 86% for amoxicillin (p>0.9). After adjustment with the propensity score, the hazard ratio (HR) for treatment failure with FQs compared to amoxicillin was 0.86 (95% CI: 0.525-1.400, p=0.53). The rates of side effects and mortality were similar between the two groups. Conclusion: the 12-week cure rates after treatment with FQs and amoxicillin were similar in the treatment of enterococcal UTIs, suggesting comparable efficacy.