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.
127-132
Butler, Christopher C.
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O'Brien, Kathryn
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Wootton, Mandy
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Pickles, Timothy
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Hood, Karenza
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Howe, Robin
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Waldron, Cherry-Ann
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Thomas-Jones, Emma
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Dudley, Jan
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Van Der Voort, Judith
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Rumsby, Kate
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Little, Paul
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Downing, Harriet
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Harman, Kim
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Hay, Alastair D.
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April 2016
Butler, Christopher C.
2782a915-eb8d-48bb-ae70-118114697f57
O'Brien, Kathryn
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Wootton, Mandy
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Pickles, Timothy
d6ba6e68-3426-407e-93b2-04b588365fe3
Hood, Karenza
f5034ac2-a99c-45e2-9f91-85f5407d7805
Howe, Robin
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Waldron, Cherry-Ann
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Thomas-Jones, Emma
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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), .
(doi:10.1093/fampra/cmv104).
(PMID:26984993)
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.
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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
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Local EPrints ID: 390642
URI: http://eprints.soton.ac.uk/id/eprint/390642
ISSN: 0263-2136
PURE UUID: 3f58fb3c-0715-4062-b27f-d221d1ce90b3
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Date deposited: 07 Apr 2016 08:03
Last modified: 12 Jul 2024 04:08
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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:
Harriet Downing
Author:
Kim Harman
Author:
Alastair D. Hay
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