RT Journal Article
SR Electronic
T1 Antibiotic resistance in children with complicated urinary tract infection
JF Saudi Medical Journal
JO Saudi Med J
FD Prince Sultan Military Medical City
SP 1850
OP 1854
VO 28
IS 12
A1 Yildiz, Bilal
A1 Kural, Nurdan
A1 Durmaz, Gul
A1 Yarar, Coskun
A1 Ak, Ilknur
A1 Akcar, Nevbahar
YR 2007
UL http://smj.org.sa/content/28/12/1850.abstract
AB OBJECTIVE: To determine the resistance of antibiotics for complicated urinary tract infection (UTI), including urinary tract anomaly (UTA), for empirical antibiotic therapy of complicated UTI.METHODS: Four hundred and twenty urine isolates were obtained from 113 patients with recurrent UTI, who used prophylactic antibiotics between February 1999 and November 2004 in the Eskisehir Osmangazi University, Eskisehir, Turkey.RESULTS: Reflux was found to be the most important predisposing factor for recurrent UTI (31.9%). Renal scar was detected more in patients with UTA than without UTA (59.2% versus 12.4%, p<0.05). Gram-negative organisms were dominant in patients with and without UTA (91.5% and 79.2%). Enterococci and Candida spp. were more prevalent in children with UTA than without UTA (p<0.001). Isolates were significantly more resistant to ampicillin, trimethoprim-sulfamethoxazole, amikacin, co-amoxiclav, ticarcillin-clavulanate, and piperacillin-tazobactam in patients with UTA than without UTA. We found low resistance to ciprofloxacin and nitrofurantoin in UTI with and without UTA. Enterococci spp. was highly resistance to ampicillin and amikacin in patients with UTA.CONCLUSION: Aztreonam, meropenem, and ciprofloxacin seemed to be the best choice for treatment of UTI with UTA due to Escherichia coli and Klebsiella spp. Nitrofurantoin and nalidixic acid may be first choice antibiotics for prophylaxis in UTI with and without UTA. The UTI with UTA caused by Enterococci spp. might not benefit from a combination of amikacin and ampicillin, it could be treated with glycopeptides.