Panelists discuss how newer urinary tract infection (UTI) therapies such as pivmecillinam, sulopenem etzadroxil/probenecid, and gepotidacin demonstrate significantly lower resistance rates (below 5%) compared with traditional first-line antibiotics (10%-30% for trimethoprim/sulfamethoxazole), with improved clinical and microbiological cure rates particularly for resistant pathogens, anticipating their integration into treatment algorithms as second-line options after nitrofurantoin and fosfomycin for patients with risk factors for resistance, prior treatment failures, recurrent infections, or confirmed resistant pathogens, although limited by higher costs and need for antimicrobial stewardship until more real-world effectiveness data become available.
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