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SHORT COMMUNICATION
Year : 2012  |  Volume : 1  |  Issue : 3  |  Page : 204-206

Drug-resistant Gram-negative bacilli in urinary tract infection: A need for strict antibiotic prescription policy


Department of Microbiology, G B Pant Hospital, New Delhi, India

Correspondence Address:
Abha Sharma
Department of Microbiology, G B Pant Hospital, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-344X.105090

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Introduction: The etiology of urinary tract infections (UTIs) and the antibiotic resistance of uropathogens have been changing over the past years. This retrospective study was conducted to survey the resistance pattern of Gram-negative uropathogens to first-line agents for UTIs; this would be helpful for the clinicians to facilitate the empiric treatment and management of patients with UTI and maybe useful for the formulation of guidelines of antibiotic policies. Materials and Methods: Isolated uropathogens were tested against ampicillin-sulbactam, amikacin, ceftriaxone, cefotaxime, cefoperazone, gentamicin, norfloxacin, ofloxacin, piperacillin-tazobactam, and imipenem. Result: A total of 2,146 urine samples were cultured, of which 448 samples were positive for Gram-negative bacilli. The most common Gram-negative isolate was Esherichia coli (52%) followed by Klebsiella pneumoniae (17.6%) and Pseudomonas aeruginosa (12.9%). E. coli was found to be most resistant to ampicillin-sulbactam (90.1%), followed by norfloxacin (76.3%), and most sensitive to imipenem. P. aeruginosa was least resistant to amikacin (27.5%). Overall resistance to imipenem is less than 20% among the Gram-negative uropathogens except Acinetobacter spp. and P. aeruginosa. Conclusion: Ofloxacin and amikacin are recommended as the drugs of choice for the empirical treatment of UTI, whereas specific treatment should be based on the etiological agent isolated in the urine culture. There is a strict need for developing specific guidelines for antibiotic prescriptions for UTI in India.


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