Antibiotic resistance of coliform organisms from community-acquired urinary tract infections in Zenica-Doboj Canton, Bosnia and Herzegovina

Abstract

Due to high ampicillin and trimethoprim/sulfamethoxazole resistance rates for all subsets analysed it is highly recommended to perform urinalysis and antibiotic susceptibility testing in all patients, except in the age group 0-6 years of male patients and in the age group 20-64 years of female patients, in which empirical therapy with these antibiotics can be applied. Nitrofurantoin should also be considered as the first-line therapy, especially in children. It is important for physicians to know susceptibility data for UTIs in order to optimize the use of empirical therapy.

Rational Therapy of Urinary Tract Infections in Children in Croatia

“…Th e most likely explanation for this low bacterial sensitivity is its widespread use for UTI chemoprophylaxis in Croatia. Similar observations were noticed in the neighboring countries 6,7,23,24 . Its oral administration in UBR group cannot be labeled as a fi rst-line antibiotic choice as its resistance rate makes this drug less suitable for empirical treatment 25,28 .…”

“…4). Studies in Croatia, neighboring countries and world population show even higher percentage of bacterial resistance 3,5,7,[22][23][24][25][26] . As the highest resistance is recorded in neonates, single ampicillin administration cannot be recommended 27 .…”

“…It makes ceftriaxone very suitable for the UBR group of patients. It has already been recommended by previous studies in Croatia and neighboring countries, as well as by NICE recommendations as fi rst line parenteral therapy [2][3][4][5]7,10,14,22,23,25,31 . We also agree with these conclusions.…”

“…Th e existing therapeutic guidelines on managing UTI in Croatian children are nearly 10 years old 4,5 . We propose UTI antibiotic administration taking into account clinical experiences, current bacterial resistance and local directing regimen in Croatia and its neighboring countries (Bosnia and Herzegovina, Serbia and Slovenia) that are infl uencing microbial fl ora in Croatia and vice versa 2,[6][7][8][9] . Our antibiotic proposals comprise fi nancial aspects of therapy as well.…”

An audit of antibiotic resistance in urinary tract infection

“…Most authors agree that sensitivity testing is necessary for complicated UTI as resistance appears to be higher in these groups. [1][2][3][4] The choice of empirical therapy is based on the likely pathogens, and consideration must also be given to evolving local resistance patterns. It may therefore be prudent to examine the sensitivity of local pathogens to allow confident prescription of empirical therapy.…”