Which antibiotics should we prefer empirical treatment of urinary tract infections in elderly patients?
Abstract
Aim: Urinary tract infection (UTI) is a major cause of mortality and morbidity in elderly patients. In this cross-sectional study, we aimed to determine the frequency and antibiotic resistance profile of the bacteria causing UTI and contribute to the empirical treatment options in elderly patients. Methods: This study included urine culture results from 347 elderly outpatients who were referred to Karabuk Training and Research Hospital between January 2018 and June 2019. The identification and antibiotic susceptibilities of microorganisms were determined using the BD-Phoenix 100 fully automated system, and the extended-spectrum beta-lactamase (ESBL) positivity was analyzed using the combined disk diffusion method. The results were retrospectively analyzed. Results: The most common pathogens were Escherichia coli (58%), Enterococcus spp. (18%) and Klebsiella pneumoniae (11%). The rate of resistance to ampicillin, amoxicillin-clavulanic acid, trimethoprim-sulfamethoxazole (TMP-SMX), cefixime, and ciprofloxacin, which are oral antibiotics used in the treatment of UTI, was between 30% and 70%. The rate of resistance to nitrofurantoin was 3%. The gentamicin and piperacillin-tazobactam resistance were 12% and 9%, respectively. The ESBL positivity for E. coli and K. pneumoniae were 29% and 49%, respectively (P=0.03). Conclusion: The rates of resistance to oral antibiotics such as ampicillin, amoxicillin-clavulanic acid, TMP-SMX, cefixime, and ciprofloxacin, which are used treatment…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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