Is it Acceptable to Select Antibiotics for the Treatment of Community-acquired Acute Cystitis Based on the Antibiotics Susceptibility Results for Uropathogens from Community-acquired Acute Pyelonephritis in Korea?

• Published in: Infection & chemotherapy Vol. 44; no. 4; pp. 269 - 274
• Main Authors: Kim, B, Kim, J, Wie, S-H, Park, SH, Cho, Y K, Lim, S-K, Shin, SY, Yum, J S, Lee, J S, Kweon, K T, Lee, H, Cheong, HJ, Park, D W, Pai, H
• Format: Journal Article
• Language: English
• Published: 01.08.2012
• Subjects: Ampicillin; Antibiotics; Antimicrobial agents; Cephalosporins; Ciprofloxacin; Cystitis; Data processing; Escherichia coli; Etiology; Hospitals; Infection; Pathogens; Pyelonephritis; Sulbactam; Sulfamethoxazole; Trimethoprim; Urine
• ISSN: 2093-2340

Background: Uncomplicated acute cystitis (CA-UAC) is one of the most common infections treated with antibiotics in the community. However, few data on etiology of CA-UAC and its susceptibility to antibiotics are available, primarily because, in Korea, insurance does not allow reimbursement for microbiological evaluation of CA-UAC. However, microbiologic data on community-acquired uncomplicated acute pyelonephritis (CA-UAPN) are available. The objective of the study was to evaluate the question of whether microbiologic data on CA-UAPN can be used for treatment of CA-UAC; therefore, etiology and antimicrobial susceptibility were compared between pathogens of CA-UAC and those of CA-UAPN. Materials and Methods: During 2008, 538 CA-UACs and 1,265 CA-UAPNs were recruited retrospectively from 14 hospitals (UTI research group). Microbiologic data on etiology and susceptibility to antibiotics were collected retrospectively. Results: Urine culture was positive in 131 CA-UACs (131/469, 27.9%) and 719 CA-UAPNs (719/1249, 57.6%). Escherichia coli was the most common pathogen in both groups [83.2% (109/131) in CA-UAC vs. 91.9% (661/719) in CA-UAPN]. Susceptibility to common UTI regimens, such as ciprofloxacin, extended-spectrum cephalosporins, and trimethoprim/sulfamethoxazole did not differ between urinary pathogens of CA-UACs and CA-UAPNs, however, a significant difference was observed in rates of resistance to ampicillin/sulbactam (16.5% vs. 42.9%, P<0.001, respectively). Conclusions: Rates of resistance of E. coli from CA-UAC and CA-UAPN to most antibiotics did not differ. For proper treatment, further microbiological evaluation for CA-UAC is mandatory.