Treatment of uncomplicated symptomatic urinary tract infections: Resistance patterns and misuse of antibiotics
Introduction: Uncomplicated but symptomatic urinary tract infections (UTIs) are a common problem seen in practice. The study was undertaken to assess the most common pathogens responsible for uncomplicated symptomatic UTIs and the antimicrobial resistance pattern in a hospital in Bangalore. The stud...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2015-01-01
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| Series: | Journal of Family Medicine and Primary Care |
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| Online Access: | http://www.jfmpc.com/article.asp?issn=2249-4863;year=2015;volume=4;issue=3;spage=416;epage=421;aulast=George |
| _version_ | 1817998714512343040 |
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| author | Carolin Elizabeth George Gift Norman G Venkata Ramana Devashri Mukherjee Tata Rao |
| author_facet | Carolin Elizabeth George Gift Norman G Venkata Ramana Devashri Mukherjee Tata Rao |
| author_sort | Carolin Elizabeth George |
| collection | DOAJ |
| description | Introduction: Uncomplicated but symptomatic urinary tract infections (UTIs) are a common problem seen in practice. The study was undertaken to assess the most common pathogens responsible for uncomplicated symptomatic UTIs and the antimicrobial resistance pattern in a hospital in Bangalore. The study also explores the issue of antibiotic usage for these patients. Materials and Methods: The study was conducted in the Medicine department of a tertiary hospital in Bangalore. In all, 196 patients presented with symptoms of UTI. Bacterial growth was determined by standard microbiology techniques on freshly voided mid-steam urine samples collected from recruited patients. Patients′ demographic data, urine culture results, resistance rates to antimicrobial agents and prescribed empiric antimicrobial therapy were analyzed. Results: The prevalence of UTI was 32.1%; majority (67.9%) of the symptomatic did not have UTI based on culture report. Gram-negative bacteria constituted the largest group with a prevalence of 84.1% (53/63), with Escherichia coli being the most common (70%) uropathogen. Gram-negative isolates showed high level of sensitivity to amikacin (90.6%) and nitrofurantoin (77.4%). Most of the gram-positive organisms were susceptible to nitrofurantoin (70%) and gentamicin (50%). Uropathogens isolated demonstrated high resistance to cotrimoxazole, fluoroquinolones, and beta-lactam antibiotics. It was found out that 30.1% of the patients were wrongly managed of which 14.7% were over treated. Conclusion: UTI can be over diagnosed and over treated on the basis of clinical signs, symptoms and urine microscopy. In the era of emerging anti-microbial resistance, effective counseling and delay in antibiotic initiation or empirical therapy with a short course of nitrofurantoin is highly recommended. Empirical therapy guidelines should be updated periodically to reflect changes in antimicrobial resistance of uropathogens. |
| first_indexed | 2024-04-14T02:57:34Z |
| format | Article |
| id | doaj.art-f5bd6a99809044fabea8f2ca8426e3cc |
| institution | Directory Open Access Journal |
| issn | 2249-4863 |
| language | English |
| last_indexed | 2024-04-14T02:57:34Z |
| publishDate | 2015-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Family Medicine and Primary Care |
| spelling | doaj.art-f5bd6a99809044fabea8f2ca8426e3cc2022-12-22T02:16:02ZengWolters Kluwer Medknow PublicationsJournal of Family Medicine and Primary Care2249-48632015-01-014341642110.4103/2249-4863.161342Treatment of uncomplicated symptomatic urinary tract infections: Resistance patterns and misuse of antibioticsCarolin Elizabeth GeorgeGift NormanG Venkata RamanaDevashri MukherjeeTata RaoIntroduction: Uncomplicated but symptomatic urinary tract infections (UTIs) are a common problem seen in practice. The study was undertaken to assess the most common pathogens responsible for uncomplicated symptomatic UTIs and the antimicrobial resistance pattern in a hospital in Bangalore. The study also explores the issue of antibiotic usage for these patients. Materials and Methods: The study was conducted in the Medicine department of a tertiary hospital in Bangalore. In all, 196 patients presented with symptoms of UTI. Bacterial growth was determined by standard microbiology techniques on freshly voided mid-steam urine samples collected from recruited patients. Patients′ demographic data, urine culture results, resistance rates to antimicrobial agents and prescribed empiric antimicrobial therapy were analyzed. Results: The prevalence of UTI was 32.1%; majority (67.9%) of the symptomatic did not have UTI based on culture report. Gram-negative bacteria constituted the largest group with a prevalence of 84.1% (53/63), with Escherichia coli being the most common (70%) uropathogen. Gram-negative isolates showed high level of sensitivity to amikacin (90.6%) and nitrofurantoin (77.4%). Most of the gram-positive organisms were susceptible to nitrofurantoin (70%) and gentamicin (50%). Uropathogens isolated demonstrated high resistance to cotrimoxazole, fluoroquinolones, and beta-lactam antibiotics. It was found out that 30.1% of the patients were wrongly managed of which 14.7% were over treated. Conclusion: UTI can be over diagnosed and over treated on the basis of clinical signs, symptoms and urine microscopy. In the era of emerging anti-microbial resistance, effective counseling and delay in antibiotic initiation or empirical therapy with a short course of nitrofurantoin is highly recommended. Empirical therapy guidelines should be updated periodically to reflect changes in antimicrobial resistance of uropathogens.http://www.jfmpc.com/article.asp?issn=2249-4863;year=2015;volume=4;issue=3;spage=416;epage=421;aulast=GeorgeAnti microbial resistancemanagementurinary tract infection |
| spellingShingle | Carolin Elizabeth George Gift Norman G Venkata Ramana Devashri Mukherjee Tata Rao Treatment of uncomplicated symptomatic urinary tract infections: Resistance patterns and misuse of antibiotics Journal of Family Medicine and Primary Care Anti microbial resistance management urinary tract infection |
| title | Treatment of uncomplicated symptomatic urinary tract infections: Resistance patterns and misuse of antibiotics |
| title_full | Treatment of uncomplicated symptomatic urinary tract infections: Resistance patterns and misuse of antibiotics |
| title_fullStr | Treatment of uncomplicated symptomatic urinary tract infections: Resistance patterns and misuse of antibiotics |
| title_full_unstemmed | Treatment of uncomplicated symptomatic urinary tract infections: Resistance patterns and misuse of antibiotics |
| title_short | Treatment of uncomplicated symptomatic urinary tract infections: Resistance patterns and misuse of antibiotics |
| title_sort | treatment of uncomplicated symptomatic urinary tract infections resistance patterns and misuse of antibiotics |
| topic | Anti microbial resistance management urinary tract infection |
| url | http://www.jfmpc.com/article.asp?issn=2249-4863;year=2015;volume=4;issue=3;spage=416;epage=421;aulast=George |
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