Trimethoprim-Sulfamethoxazole is no longer effective for uncomplicated UTIs.
There's lots of talk about the increasing resistance of E. coli to TMP-SMX (Bactrim, Septra, etc). But in many areas, E. coli is still susceptible to TMP-SMX. Nevertheless, many clinicians are automatically reaching for quinolones...even in areas with little resistance.
Now experts are concerned about quinolones being overused for uncomplicated urinary tract infections (UTIs). In fact, quinolone resistance is on the rise in some areas.
TMP-SMX is still preferred for uncomplicated UTIs...UNLESS local resistance is higher than 20%.