Choice of antibiotic for empirical therapy of acute cystitis in a setting of high antimicrobial resistance.
Indian J Med Sci
;
2006 Feb; 60(2): 53-8
Artigo
em Inglês
| IMSEAR
| ID: sea-66365
ABSTRACT
BACKGROUND:
A high prevalence of antimicrobial resistance among urinary isolates in the Garhwal region of Uttaranchal.AIMS:
To identify the most appropriate antibiotic for empirical treatment of community-acquired acute cystitis on the basis of local antimicrobial sensitivity profile. SETTINGS ANDDESIGN:
A prospective clinico-microbiological study including all clinically diagnosed patients with community acquired acute cystitis attending a tertiary care teaching hospital over a period of three years. METHODS ANDMATERIAL:
Clean-catch midstream urine specimens, from 524 non-pregnant women with community-acquired acute cystitis, were subjected to semi-quantitative culture and antibiotic susceptibility by the Kirby- Bauer disc diffusion method. A survey was also conducted on 30 randomly selected local practitioners, to know the prevalent prescribing habits in this condition. STATISTICALANALYSIS:
The difference between the susceptibility rates of E. coli isolates to Nitrofurantoin and the other commonly prescribed antibiotics was analysed by applying the z test for proportion.RESULTS:
354 (67.5%) specimens yielded significant growth of E. coli.> 35% of the urinary E.coli isolates were resistant to the fluoroquinolones, which were found to be the most commonly used empirical antibiotics in acute cystitis. Resistance was minimum against Nitrofurantoin (9.3%, 33) and Amikacin (11.0%,39).> 80% of the fluoroquinolone-resistant strains were found to be sensitive to Nitrofurantoin.CONCLUSION:
The best in vitro susceptibility profile in our study has been shown by Nitrofurantoin and a significantly high proportion of the urinary E. coli isolates have already developed resistance to the currently prescribed empirical antibiotics, viz. the fluoroquinolones. In view of these in vitro susceptibility patterns, a transition in empirical therapy appears imminent.
Texto completo:
DisponíveL
Índice:
IMSEAR (Sudeste Asiático)
Assunto principal:
Proteus
/
Staphylococcus
/
Infecções Bacterianas
/
Urina
/
Feminino
/
Humanos
/
Resistência Microbiana a Medicamentos
/
Testes de Sensibilidade Microbiana
/
Doença Aguda
/
Estudos Prospectivos
Tipo de estudo:
Estudo observacional
País/Região como assunto:
Ásia
Idioma:
Inglês
Revista:
Indian J Med Sci
Ano de publicação:
2006
Tipo de documento:
Artigo
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