Public Health Institute, Split, Croatia
Objectives: To determine in vitro susceptibility of E. coli isolates in community acquired urinary tract infections (CA-UTI) and to suggest optimal empirical antibiotic therapy in these patients.
Methods: Three hundred fifthy seven consecutive strains of E. coli isolated from patients with CA-UTI were included in this study. Isolation and identification were performed by standard method and susceptibillity testing was performed by disk diffusion method. Susceptibillity was tested to amoxycillin (AMX), amoxycillin-clavulanate (AMC), cephalexin (CN), cefuroxime (CXM), ceftibuten (CTB), trimethoprim-sulfamethoxazole (STX) and ciprofloxacin (CIP).
Results: From total number of 357 strains of E. coli 44,32 % were resistant to AMX, 3,92 % to AMC, 4,76 % to CN, 2,24 % to CXM, 0,84 % to CTB, 17,09 % to STX and 1,77 % strains were resistant to CIP.
Conclusions: The best in vitro susceptibillity was shown for
ceftibuten, followed by ciprofloxacin and cefuroxime. Strains of E.
coli show high resistance rate to trimethoprim-sulfamethoxazole and
amoxycillin.
The antibiotic of the best choice for empirical antibiotic therapy
in patients with CA-UTI in our region is ceftibuten. Drugs like trimethoprim-sulphametoxazol
or amoxycillin, most often prescribed in empirical therapy of CA-UTI, are
not a good choice, because strains of E. coli show high rate of in vitro
resistance to these antibiotics.