The University of Southampton
University of Southampton Institutional Repository

Empiric antibiotic treatment for urinary tract infection in preschool children: susceptibilities of urine sample isolates

Empiric antibiotic treatment for urinary tract infection in preschool children: susceptibilities of urine sample isolates
Empiric antibiotic treatment for urinary tract infection in preschool children: susceptibilities of urine sample isolates
Background: Antibiotic treatment recommendations based on susceptibility data from routinely submitted urine samples may be biased because of variation in sampling, laboratory procedures and inclusion of repeat samples, leading to uncertainty about empirical treatment.

Objective: To describe and compare susceptibilities of Escherichia coli cultured from routinely submitted samples, with E. coli causing urinary tract infection (UTI) from a cohort of systematically sampled, acutely unwell children.

Methods: Susceptibilities of 1458 E. coli isolates submitted during the course of routine primary care for children <5 years (routine care samples), compared to susceptibilities of 79 E. coli isolates causing UTI from 5107 children <5 years presenting to primary care with an acute illness [systematic sampling: the Diagnosis of Urinary Tract infection in Young children (DUTY) cohort].

Results: The percentage of E. coli sensitive to antibiotics cultured from routinely submitted samples were as follows: amoxicillin 45.1% (95% confidence interval: 42.5–47.7%); co-amoxiclav using the lower systemic break point (BP) 86.6% (84.7–88.3%); cephalexin 95.1% (93.9–96.1%); trimethoprim 74.0% (71.7–76.2%) and nitrofurantoin 98.2% (97.4–98.8%). The percentage of E. coli sensitive to antibiotics cultured from systematically sampled DUTY urines considered to be positive for UTI were as follows: amoxicillin 50.6% (39.8–61.4%); co-amoxiclav using the systemic BP 83.5% (73.9–90.1%); co-amoxiclav using the urinary BP 94.9% (87.7–98.4%); cephalexin 98.7% (93.2–99.8%); trimethoprim 70.9% (60.1–80.0%); nitrofurantoin 100% (95.3–100.0%) and ciprofloxacin 96.2% (89.4–98.7%).

Conclusion: Escherichia coli susceptibilities from routine and systematically obtained samples were similar. Most UTIs in preschool children remain susceptible to nitrofurantoin, co-amoxiclav and cephalexin.
0263-2136
127-132
Butler, Christopher C.
2782a915-eb8d-48bb-ae70-118114697f57
O'Brien, Kathryn
29e28cdd-fb6e-4df8-ad43-3a5fd7fd20ad
Wootton, Mandy
d0cbb02c-9039-42f8-98d1-62d741bd42e5
Pickles, Timothy
d6ba6e68-3426-407e-93b2-04b588365fe3
Hood, Karenza
f5034ac2-a99c-45e2-9f91-85f5407d7805
Howe, Robin
e02d3c72-421b-4396-bf99-392e8847247f
Waldron, Cherry-Ann
74f893bb-7b67-4f67-b598-7d598cfd4085
Thomas-Jones, Emma
ea15d5ac-8232-4823-ab40-17bec0968520
Dudley, Jan
d9caef7d-0a8b-4879-839e-43f347228c5e
Van Der Voort, Judith
d35b2ed1-6e26-4d2e-aa21-62cc637e78e6
Rumsby, Kate
2002ee8a-32ac-4119-869d-ed35164c3b51
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Downing, Harriet
6f9fc478-f778-4eae-b5ef-f4d3430d59db
Harman, Kim
de036b2f-da30-4cb7-bfaf-d709e84ca825
Hay, Alastair D.
bfae9e44-ae9b-473c-923f-1dea50747023
Butler, Christopher C.
2782a915-eb8d-48bb-ae70-118114697f57
O'Brien, Kathryn
29e28cdd-fb6e-4df8-ad43-3a5fd7fd20ad
Wootton, Mandy
d0cbb02c-9039-42f8-98d1-62d741bd42e5
Pickles, Timothy
d6ba6e68-3426-407e-93b2-04b588365fe3
Hood, Karenza
f5034ac2-a99c-45e2-9f91-85f5407d7805
Howe, Robin
e02d3c72-421b-4396-bf99-392e8847247f
Waldron, Cherry-Ann
74f893bb-7b67-4f67-b598-7d598cfd4085
Thomas-Jones, Emma
ea15d5ac-8232-4823-ab40-17bec0968520
Dudley, Jan
d9caef7d-0a8b-4879-839e-43f347228c5e
Van Der Voort, Judith
d35b2ed1-6e26-4d2e-aa21-62cc637e78e6
Rumsby, Kate
2002ee8a-32ac-4119-869d-ed35164c3b51
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Downing, Harriet
6f9fc478-f778-4eae-b5ef-f4d3430d59db
Harman, Kim
de036b2f-da30-4cb7-bfaf-d709e84ca825
Hay, Alastair D.
bfae9e44-ae9b-473c-923f-1dea50747023

Butler, Christopher C., O'Brien, Kathryn, Wootton, Mandy, Pickles, Timothy, Hood, Karenza, Howe, Robin, Waldron, Cherry-Ann, Thomas-Jones, Emma, Dudley, Jan, Van Der Voort, Judith, Rumsby, Kate, Little, Paul, Downing, Harriet, Harman, Kim and Hay, Alastair D. (2016) Empiric antibiotic treatment for urinary tract infection in preschool children: susceptibilities of urine sample isolates. Family Practice, 33 (2), 127-132. (doi:10.1093/fampra/cmv104). (PMID:26984993)

Record type: Article

Abstract

Background: Antibiotic treatment recommendations based on susceptibility data from routinely submitted urine samples may be biased because of variation in sampling, laboratory procedures and inclusion of repeat samples, leading to uncertainty about empirical treatment.

Objective: To describe and compare susceptibilities of Escherichia coli cultured from routinely submitted samples, with E. coli causing urinary tract infection (UTI) from a cohort of systematically sampled, acutely unwell children.

Methods: Susceptibilities of 1458 E. coli isolates submitted during the course of routine primary care for children <5 years (routine care samples), compared to susceptibilities of 79 E. coli isolates causing UTI from 5107 children <5 years presenting to primary care with an acute illness [systematic sampling: the Diagnosis of Urinary Tract infection in Young children (DUTY) cohort].

Results: The percentage of E. coli sensitive to antibiotics cultured from routinely submitted samples were as follows: amoxicillin 45.1% (95% confidence interval: 42.5–47.7%); co-amoxiclav using the lower systemic break point (BP) 86.6% (84.7–88.3%); cephalexin 95.1% (93.9–96.1%); trimethoprim 74.0% (71.7–76.2%) and nitrofurantoin 98.2% (97.4–98.8%). The percentage of E. coli sensitive to antibiotics cultured from systematically sampled DUTY urines considered to be positive for UTI were as follows: amoxicillin 50.6% (39.8–61.4%); co-amoxiclav using the systemic BP 83.5% (73.9–90.1%); co-amoxiclav using the urinary BP 94.9% (87.7–98.4%); cephalexin 98.7% (93.2–99.8%); trimethoprim 70.9% (60.1–80.0%); nitrofurantoin 100% (95.3–100.0%) and ciprofloxacin 96.2% (89.4–98.7%).

Conclusion: Escherichia coli susceptibilities from routine and systematically obtained samples were similar. Most UTIs in preschool children remain susceptible to nitrofurantoin, co-amoxiclav and cephalexin.

Text
09.12.15 DUTY SENSITIVTIES PAPER Family Practice clean copy.docx - Accepted Manuscript
Download (73kB)
Text
__userfiles.soton.ac.uk_Users_nl2_mydesktop_Deposits_One off_Family Practice-2016-Butler-127-32 Duty susceptibilities.pdf - Version of Record
Restricted to Repository staff only
Request a copy

More information

Accepted/In Press date: 18 December 2015
e-pub ahead of print date: 16 March 2016
Published date: April 2016
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 390642
URI: http://eprints.soton.ac.uk/id/eprint/390642
ISSN: 0263-2136
PURE UUID: 3f58fb3c-0715-4062-b27f-d221d1ce90b3
ORCID for Kate Rumsby: ORCID iD orcid.org/0000-0002-8573-3718
ORCID for Paul Little: ORCID iD orcid.org/0000-0003-3664-1873
ORCID for Kim Harman: ORCID iD orcid.org/0000-0002-5173-7753

Catalogue record

Date deposited: 07 Apr 2016 08:03
Last modified: 12 Jul 2024 04:08

Export record

Altmetrics

Contributors

Author: Christopher C. Butler
Author: Kathryn O'Brien
Author: Mandy Wootton
Author: Timothy Pickles
Author: Karenza Hood
Author: Robin Howe
Author: Cherry-Ann Waldron
Author: Emma Thomas-Jones
Author: Jan Dudley
Author: Judith Van Der Voort
Author: Kate Rumsby ORCID iD
Author: Paul Little ORCID iD
Author: Harriet Downing
Author: Kim Harman ORCID iD
Author: Alastair D. Hay

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×