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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Dr Gupta and colleagues¹ identified an increasing prevalence of antimicrobial resistance among uropathogens causing acute uncomplicated cystitis. In the United Kingdom, one of the recommendations of the Standing Medical Advisory Committee regarding antimicrobial resistance was to limit antibiotic prescribing in uncomplicated cystitis to 3 days in otherwise fit young women with cystitis."²

Studies have suggested a benefit of a nonantimicrobial cranberry juice in an elderly patient population³ and have found that components of cranberry juice inhibit the lectin-mediated adherence of Escherichia coli to urinary mucosal cells via the pili on the surface of the bacteria.⁴ Perhaps efforts to limit overuse of antimicrobials should include the humble cranberry.

Ian R. Daniels, FRCS; Sonya R. Zaman, MBBS
St Richard's Hospital
West Sussex, England

1. Gupta K, Scholes D, Stamm WE. Increasing prevalence of antimicrobial resistance among uropathogens causing acute uncomplicated cystitis in women. JAMA. 1999;281:736-738. FREE FULL TEXT 2. United Kingdom Department of Health. Report on the Impact of Clinical Prescribing on Antimicrobial Resistance [press release]. United Kingdom; September 3, 1998. 3. Avorn J, Monane M, Gurwitz JH, Glynn RJ, Choodnovskiy I, Lipsitz LA. Reduction of bacteriuria and pyuria after ingestion of cranberry juice. JAMA. 1994;271:751-754. FREE FULL TEXT 4. Zafiri D, Ofek I, Adar R, et al. Inhibitory activity of cranberry juice on adherence of type 1 and P fimbriated E. coli to eukaryotic cells. Antimicrob Agents Chemother. 1989;33:92-98. FREE FULL TEXT

In Reply: As pointed out by Drs Daniels and Zaman, cranberry juice contains compounds that competitively inhibit the attachment of E coli to uroepithelial cells.¹ In . . . [Full Text of this Article]

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RELATED ARTICLE

Increasing Prevalence of Antimicrobial Resistance Among Uropathogens Causing Acute Uncomplicated Cystitis in Women
Kalpana Gupta, Delia Scholes, and Walter E. Stamm
JAMA. 1999;281(8):736-738.
ABSTRACT | FULL TEXT