Choice of Antibiotics in Community Acquired UTI due to Escherichia Coli in Adult Age group 483-485
Prof. Varsha Gupta, Department of Microbiology
Government Medical College Hospital
Sector-32, Chandigarh-160 030
Telephone no.: 09646121571
Background: Urinary tract infections (UTI), being the most common infections diagnosed in community and hospital, are to be treated scrupulously considering the type of infecting organism and its antibiotic resistance pattern. The study of changing antibiotic resistance pattern is pertinent for appropriate treatment.
Aim: The aim of this study was to find out the drug options for treatment of community acquired urinary tract infection (UTI) due to Escherichia coli in adult age group in our geographical area in the current scenario of increasing antimicrobial resistance.
Setting and Design: A total of 208 Escherichia coli isolates from urine of adult patients presenting in various out patient department of Government Medical College & Hospital, Chandigarh were studied between January 2009 to June 2009. Antimicrobial susceptibility of various drugs was carried out by disc diffusion method following CLSI guidelines.
Results: Amongst the orally administered drugs ampicillin, amoxycillin/clavulanic acid, norfloxacin, ciprofloxacin, tetracycline and co-trimoxazole showed 100%, 83.6%, 78.1%, 72.5%, 69.1% and 69% resistance respectively. Amongst parenterally administered antibiotics, the antimicrobial resistance for cefotaxime, ceftazidime, gentamicin, netilmicin and amikacin was found to be 58.8%, 67.2%, 18.7%, 4.8% and 4.6% respectively. Nitrofurantoin showed only 3.8% resistance. No drug resistance was seen with imipenem.
Conclusion: Amongst oral drugs, nitrofurantoin was shown to be suitable for the treatment of UTI due to Escherichia coli. Ampicillin, amoxycillin/clavulanic acid, norfloxacin, ciprofloxacin, tetracycline, co-trimoxazole should no longer be considered first line drugs for empirical treatment of clinically evident UTI because of very high resistance rates. Aminoglycosides though parentral drugs can be the alternative choice for community acquired UTI.