Antibiotic treatment and antimicrobial resistance in children with urinary tract infections

Journal of Global Antimicrobial Resistance

A. Anastasiou-Katsiardani¹  K. Velali²  I. Tassiou³  T. Zaoutis⁴  K. Athanasopoulou⁵  L. Folgori⁶  Y. Hsia⁷  R. Basmaci⁸  C. Jackson⁹  A. Barbouni^1,10  K. Vazouras^1,11 

[1] Corresponding author. Present address: The Stavros Niarchos Foundation–Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), 5 Chatzigianni Mexi, Athens 11528, Greece.;Paediatric Infectious Diseases Research Group, Institute for Infection and Immunity, St George’s University of London, London SW17 0RE, UK;Second Department of Pediatrics, Aghia Sophia Children΄s Hospital, Agia Sophia Hospital, Goudi, Athens, Greece;Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece;First Department of Pediatrics, Aghia Sophia Children's Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece;Microbiology Department, Achillopouleion General Hospital of Volos, Volos, Greece;Paediatric Infectious Disease Unit, Department of Paediatrics, Luigi Sacco Hospital, University of Milan, Milan, Italy;Paediatric Infectious Diseases Research Group, Institute for Infection and Immunity, St George’s University of London, London SW17 0RE, UK;Paediatrics Department, Achillopouleion General Hospital of Volos, Volos, Greece;Paediatrics Department, University Hospital of Larissa, Larissa, Greece;The Stavros Niarchos Foundation–Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), University of Athens, Athens, Greece;

关键词: Urinary tract infection;    UTI;    Antibiotic prescribing;    Antimicrobial resistance;    Children;   

DOI  :  

来源: DOAJ

【 摘 要 】

Objectives: The aim of this study was to describe antibiotic prescribing patterns and antimicrobial resistance rates in hospitalised children with febrile and afebrile urinary tract infections (UTIs). Methods: Antibiotic prescriptions and antibiograms for neonates, infants and older children with UTI admitted to a general district hospital in Central Greece were evaluated. Data covering a 5-year period were collected retrospectively from the Paediatric Department’s Electronic Clinical Archive. Patients were included based on clinical and microbiological criteria. Antimicrobial susceptibility was determined by the Kirby–Bauer disk diffusion method. Results: A total of 230 patients were included in the study. Among 459 prescriptions identified, amikacin (31.2%) was the most common antibiotic prescribed in this population, followed by amoxicillin/clavulanic acid (17.4%) and ampicillin (13.5%). Children received prolonged intravenous (i.v.) treatments for febrile (mean ± S.D., 5.4 ± 1.45 days) and afebrile UTIs (mean ± S.D., 4.4 ± 1.64 days). A total of 236 pathogens were isolated. The main causative organism was Escherichia coli (79.2%) with high reported resistance rates to ampicillin (42.0%), trimethoprim/sulfamethoxazole (26.5%) and amoxicillin/clavulanic acid (12.2%); lower resistance rates were identified for third-generation cephalosporins (1.7%), nitrofurantoin (2.3%), ciprofloxacin (1.4%) and amikacin (0.9%). Klebsiella spp. isolates were highly resistant to cefaclor (27.3%). Conclusion: High prescribing rates for amikacin and penicillins (± β-lactamase inhibitors) and prolonged i.v. treatments were observed. Escherichia coli was highly resistant to ampicillin, whilst third-generation cephalosporins exhibited greater in vitro efficacy. Establishment of antimicrobial stewardship programmes and regular monitoring of antimicrobial resistance could help to minimise inappropriate prescribing for UTIs.

【 授权许可】

Unknown