Uropathogen resistance to antibiotic prophylaxis in urinary tract infections.

Young children at risk of recurrent urinary tract infections are prescribed long-term antibiotic prophylaxis to prevent recurrences. As this is associated with an increased risk of resistant infections, we have analyzed the pattern of uropathogen resistance to the prescribed prophylactic antibiotic during a urinary tract infection recurrence. A cohort of 36 children aged 2 weeks to 10 years. Antimicrobial susceptibility of the isolates was tested by the disc diffusion technique. The majority were on prophylaxis with cefradine (n = 19, 53%) or cotrimoxazole (n = 11, 31%). Escherichia coli was the commonest grown organism (n = 26, 72%). Resistance occurred in 19 children (53%), with the highest for amoxicillin-clavulanate (n = 2, 100%) and nalidixic acid (n = 1, 100%), followed by cefradine (n = 10, 72%), cotrimoxazole (n = 5, 62%), and aminopenicillins (n = 1, 50%). Multidrug resistance occurred in 20 (55.5%) more commonly with cephalosporins (60% of cases) and cotrimoxazole (20%). Uropathogen resistance to prophylactic antibiotics occurs in 50% of the cases, half of which to multidrugs. Compliance to long-term prophylaxis seems to remain an important problem in the children where there was no resistance to the prescribed antibiotic.