Dong Sup Lee1, Hyun-Sop Choe1, Hee Youn Kim1, Je Mo Yoo1, Woong Jin Bae2, Yong Hyun Cho3, Sun Wook Kim3, Chang Hee Han4, Sang Rak Bae4, Hoon Jang5, Su Bum Park6, Byung Il Yoon7, Seung-Ju Lee8. 1. Department of Urology, St. Vincent's Hospital, The Catholic University of Korea, College of Medicine, 93-6 Ji-dong Paldal-gu, Suwon 442-723, Korea. 2. Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea. 3. Department of Urology, Yeouido St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea. 4. Department of Urology, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Uijeongbu, Korea. 5. Department of Urology, Daejeon St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Daejeon, Korea. 6. Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan, Korea. 7. International St. Mary's Hospital, Catholic Kwandong University, Incheon, South Korea. 8. Department of Urology, St. Vincent's Hospital, The Catholic University of Korea, College of Medicine, 93-6 Ji-dong Paldal-gu, Suwon 442-723, Korea. Electronic address: lee.seungju@gmail.com.
Abstract
OBJECTIVES: To identify the age- and sex-specific antimicrobial susceptibility patterns of Gram-negative bacteria (GNB) in outpatient febrile urinary tract infections (UTIs) in Korea. METHODS: A total 2262 consecutive samples collected from patients aged 1-101 years with febrile UTIs, during the period January 2012 to December 2014, were analyzed in this multicentre, retrospective cohort study. RESULTS: The sensitivities to cefotaxime and cefoxitin were over 85% for females but under 75% for males. Sex played an important role in the susceptibility of GNB to cefotaxime (p<0.001) and cefoxitin (p<0.001). The sensitivity to ciprofloxacin (age >20 years) was under 75% in both sexes, and was not influenced by sex (p=0.204). Age distributions of the incidences of resistance to cefotaxime, cefoxitin, and ciprofloxacin (age >20 years) were similar to the age distribution of the incidence of GNB, which indicates that the resistance patterns to these drugs were not affected by age (Kolmogorov-Smirnov test, female/male: p=0.927/p=0.509, p=0.193/p=0.911, and p=0.077/p=0.999, respectively). CONCLUSIONS: Age is not a considerable factor in determining the antibiotic resistance in febrile UTIs. Ciprofloxacin should be withheld from both sexes until culture results indicate its use. Second- or third-generation cephalosporins such as cefoxitin and cefotaxime can be used empirically only in females.
OBJECTIVES: To identify the age- and sex-specific antimicrobial susceptibility patterns of Gram-negative bacteria (GNB) in outpatientfebrile urinary tract infections (UTIs) in Korea. METHODS: A total 2262 consecutive samples collected from patients aged 1-101 years with febrile UTIs, during the period January 2012 to December 2014, were analyzed in this multicentre, retrospective cohort study. RESULTS: The sensitivities to cefotaxime and cefoxitin were over 85% for females but under 75% for males. Sex played an important role in the susceptibility of GNB to cefotaxime (p<0.001) and cefoxitin (p<0.001). The sensitivity to ciprofloxacin (age >20 years) was under 75% in both sexes, and was not influenced by sex (p=0.204). Age distributions of the incidences of resistance to cefotaxime, cefoxitin, and ciprofloxacin (age >20 years) were similar to the age distribution of the incidence of GNB, which indicates that the resistance patterns to these drugs were not affected by age (Kolmogorov-Smirnov test, female/male: p=0.927/p=0.509, p=0.193/p=0.911, and p=0.077/p=0.999, respectively). CONCLUSIONS: Age is not a considerable factor in determining the antibiotic resistance in febrile UTIs. Ciprofloxacin should be withheld from both sexes until culture results indicate its use. Second- or third-generation cephalosporins such as cefoxitin and cefotaxime can be used empirically only in females.