Community-Acquired Urinary Tract Infections: A Comparative Study Between 2013 and 2015
DOI:
https://doi.org/10.24950/O/145/20/4/2020Keywords:
Drug Resistance, Multiple, Bacterial, Community- Acquired Infections, Urinary Tract InfectionsAbstract
Introduction: Urinary tract infections (UTI) are one of the main reasons for assessing in the emergency department and for antibiotic prescribing. Our objective was to characterize the community-acquired UTI and antibiotic prescription patterns in two years.
Material and Methods: Retrospective observational study, including patients evaluated in the first semesters of 2013 and 2015 with the diagnosis of community-acquired UTI, evaluated in the adult emergency department.
Results: A total of 1981 diagnoses were identified, corresponding to 448 positive urine cultures. Escherichia coli was the most frequent bacterium, and there was a significant decrease in its prevalence between the two periods. There was a significant decrease in the resistance rate of Escherichia coli to ciprofloxacin and co-trimoxazole (trimethoprim/ sulfamethoxazole) and an increase in Klebsiella pneumoniae resistance to nitrofurantoin. Nitrofurantoin, quinolones and cephalosporins showed global sensitivities greater than 90%. In the two-year period, the prescription of quinolones decreased while that of fosfomycin and nitrofurantoin increased.
Discussion: The profile of Escherichia coli resistance to quinolones found in our study is lower than that previously documented in Portugal. Progress towards compliance with the national guideline has been made by decreasing the prescription of quinolones and co-trimoxazole, leading to an improvement in the profile of sensitivities to these antibiotics.
Conclusion: Despite the declining trend in the prescription of quinolones, this class of antibiotics is still the most prescribed, requiring optimization of local prescription.
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