ArticleBMC infectious diseases2018
Empiric antibiotic therapy in urinary tract infection in patients with risk factors for antibiotic resistance in a German emergency department.
Article in BMC infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 1 of them a synthesis that pooled it.
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Who cites it
56 citing papers in PubMed, 1 synthesis or guideline pooled it, 104 citations in OpenAlex.
- [Effect of bladder irrigation with amphotericin B for treatment of urinary tract fungal infection: a meta-analysis].Nan fang yi ke da xue xue bao = Journal of Southern Medical University · 2018Pooled it
- A clinical decision support system improves antibiotic therapy for upper urinary tract infection in a randomized single-blinded study.BMC health services research · 2020Trial
- Estimating treatment effects from non-overlapping cohorts with application to antimicrobial resistance.BMC medical research methodology · 2026Article
- Article
- Do Urologists Adhere to Antibiotic Prophylaxis Guidelines prior to Cystoscopy?Urologia internationalis · 2026Article
- A randomized, triple-blind, placebo-controlled, parallel study of the efficacy of D-mannose for urinary tract infection symptoms in women.Current urology · 2026Article
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- Pathogenic Characteristics and Molecular Epidemiological Analysis ofInfection and drug resistance · 2026Article
- Trends in Antibiotic Resistance in Uropathogens at Mbarara Regional Referral Hospital (2019-2024): A Retrospective Study.Infection and drug resistance · 2025Article
- Recurrent Urinary Tract Infections in Older Adults Requiring Hospitalization in an Internal Medicine Ward.Microorganisms · 2024Article
- Proposal and clinical validation of a perioperative algorithm enhancing antimicrobial stewardship in substitution urethroplasty.Asian journal of urology · 2024Article
- Low Concentration of Wenyang Tonglin Decoction Promotes Conjugation and Transfer of Drug-Resistant Plasmids among Heterologous Strains.Chinese journal of integrative medicine · 2024Article
- Antibiotic Resistance Trends in Uropathogens during the COVID-19 Pandemic in Western Romania: A Cross-Sectional Study.Antibiotics (Basel, Switzerland) · 2024Article
- Designing of fragment based inhibitors with improved activity againstSaudi journal of biological sciences · 2024Article
- Urinary tract infections in older adults: associated factors for extended-spectrum beta-lactamase production.Frontiers in microbiology · 2024Article
- Exploring the Dynamic Role of Bacterial Etiology in Complicated Urinary Tract Infections.Medicina (Kaunas, Lithuania) · 2023Article
- Genomic analysis of a multidrug methicillin-resistant staphylococcus epidermidis recovered from the urine of a guinea pig (Cavia porcellus) with suspected pyelonephritis.Veterinary research communications · 2023Article
- The Distribution Trend and Antimicrobial Susceptibility of Uropathogens in Taiwan: Retrospective Analysis of a 10-Year Study.Journal of acute medicine · 2023Article
- Risk Factors and the Impact of Multidrug-Resistant Bacteria on Community-Acquired Urinary Sepsis.Microorganisms · 2023Article
- Predictors of Urosepsis Post Percutaneous Nephrolithotomy at King Abdulaziz Medical City, Riyadh.Cureus · 2023Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of this study was to identify clinical risk factors for antimicrobial resistances and multidrug resistance (MDR) in urinary tract infections (UTI) in an emergency department in order to improve empirical therapy.
methodsUTI cases from an emergency department (ED) during January 2013 and June 2015 were analyzed. Differences between patients with and without resistances towards Ciprofloxacin, Piperacillin with Tazobactam (Pip/taz), Gentamicin, Cefuroxime, Cefpodoxime and Ceftazidime were analyzed with Fisher's exact tests. Results were used to identify risk factors with logistic regression modelling. Susceptibility rates were analyzed in relation to risk factors.
resultsOne hundred thirty-seven of four hundred sixty-nine patients who met the criteria of UTI had a positive urine culture. An MDR pathogen was found in 36.5% of these. Overall susceptibility was less than 85% for standard antimicrobial agents. Logistic regression identified residence in nursing homes, male gender, hospitalization within the last 30 days, renal transplantation, antibiotic treatment within the last 30 days, indwelling urinary catheter and recurrent UTI as risk factors for MDR or any of these resistances. For patients with no risk factors Ciprofloxacin had 90%, Pip/taz 88%, Gentamicin 95%, Cefuroxime 98%, Cefpodoxime 98% and Ceftazidime 100% susceptibility. For patients with 1 risk factor Ciprofloxacin had 80%, Pip/taz 80%, Gentamicin 88%, Cefuroxime 78%, Cefpodoxime 78% and Ceftazidime 83% susceptibility. For 2 or more risk factors Ciprofloxacin drops its susceptibility to 52%, Cefuroxime to 54% and Cefpodoxime to 61%. Pip/taz, Gentamicin and Ceftazidime remain at 75% and 77%, respectively.
conclusionsWe identified several risk factors for resistances and MDR in UTI. Susceptibility towards antimicrobials depends on these risk factors. With no risk factor cephalosporins seem to be the best choice for empiric therapy, but in patients with risk factors the beta-lactam penicillin Piperacillin with Tazobactam is an equal or better choice compared to fluoroquinolones, cephalosporins or gentamicin. This study highlights the importance of monitoring local resistance rates and its risk factors in order to improve empiric therapy in a local environment.
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