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[Correspondence] Ceftolozane-tazobactam versus levofloxacin in urinary tract infection

The ASPECT-cUTI trial by Florian Wagenlehner and colleagues1 reported that intravenous ceftolozane-tazobactam was not only non-inferior but also superior to intravenous levofloxacin in the composite of microbiological eradication and clinical cure of complicated urinary tract infections. In view of the increasing rate of bacteria resistant to fluoroquinolones, these findings are not unexpected.2,3 In the Netherlands, recent recommendations by the ISIS-AR study group4 no longer endorse the use of fluoroquinolones as first-line empirical treatment of complicated urinary-tract infections, but suggest initial combination treatment with either amoxicillin or amoxicillin-clavulanic acid, or a second or third generation cephalosporin and an aminoglycoside.