ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2013
Trimethoprim prescription and subsequent resistance in childhood urinary infection: multilevel modelling analysis.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Global prevalence of antibiotic resistance in paediatric urinary tract infections caused by Escherichia coli and association with routine use of antibiotics in primary care: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2016Pooled it
- Antibiotic prescribing intensity and community UTI resistance: a cross-sectional ecological study.BJGP open · 2025Article
- Primary Care Antibiotic Prescribing and Infection-Related Hospitalisation.Antibiotics (Basel, Switzerland) · 2023Review
- Antimicrobial resistance in urinary pathogens and culture-independent detection of trimethoprim resistance in urine from patients with urinary tract infection.BMC microbiology · 2022Article
- Updated Italian recommendations for the diagnosis, treatment and follow-up of the first febrile urinary tract infection in young children.Acta paediatrica (Oslo, Norway : 1992) · 2020Review
- Changes in resistance among coliform bacteraemia associated with a primary care antimicrobial stewardship intervention: A population-based interrupted time series study.PLoS medicine · 2019Observational
- Antibiotic resistance in E. coli isolates from patients with urinary tract infections presenting to the emergency department.Infection · 2018Article
- Characterization of trimethoprim resistantChemical science · 2017Article
- The relationship between prior antimicrobial prescription and meningitis: a case-control study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2016Article
- Clinical predictors of antibiotic prescribing for acutely ill children in primary care: an observational study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2015Observational
- Antimicrobial stewardship - can we afford to do without it?British journal of clinical pharmacology · 2015Article
- Dangerous Ideas: resistant superbugs and the potential of the microbiome.The British journal of general practice : the journal of the Royal College of General Practitioners · 2014Article
- Clinical options for the treatment of urinary tract infections in children.Clinical medicine insights. Pediatrics · 2014Review
- Antibiotics for childhood urinary tract infection: can we be smarter?The British journal of general practice : the journal of the Royal College of General Practitioners · 2013Article
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAntibiotic resistance is a growing concern and antibiotic usage the main contributing factor, but there are few studies examining antibiotic use and resistance in children.
aimTo investigate the association between previous trimethoprim prescribing and resistance in urinary Escherichia coli (E. coli) isolates in children. DESIGN AND
settingRetrospective, population cohort study in Tayside, Scotland.
methodMultilevel modelling of linked microbiology and dispensed prescribing data for 1373 ≤16-year-olds with E. coli urinary isolates in 2004-2009, examining the association between prior trimethoprim prescription and subsequent trimethoprim resistance in people with urinary E. coli isolates.
resultsTrimethoprim resistance was common (26.6%, 95% confidence interval [CI] = 24.6 to 28.6). Previous trimethoprim prescription was associated with subsequent culture of trimethoprim-resistant E. coli, with more recent prescription being more strongly associated with resistance. After adjusting for the number of previous E. coli isolates and sample year, trimethoprim prescribing in the previous 84 days remained significantly associated with culturing trimethoprim-resistant E. coli (adjusted OR 4.71, 95% CI = 1.83 to 12.16 for the previous 15-28 days versus never prescribed; adjusted OR 3.16, 95% CI = 1.63 to 6.13 for the previous 29-84 days); however, associations were not statistically significant for longer periods since prior exposure.
conclusionTrimethoprim prescription has implications for future resistance in individual children, as well as at population level. Clinicians must ensure appropriateness of treatment choice and duration, and alternative antibiotics should be considered for childhood urinary tract infections if trimethoprim has been prescribed in the preceding 3 months.
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