Treatment of serious urinary tract infections at a university teaching hospital: a retrospective chart review.
A retrospective chart review of all adult patients treated empirically for urinary tract infections (including pyelonephritis) with parenteral antibiotics over a 3-month period was conducted at this university teaching hospital. A total of 92 patient charts were located and reviewed. All patients had a complicating condition. Blood cultures were obtained on 67% of the patients; 23% were positive. E coli was the primary infecting organism (56%). All organisms tested against ceftriaxone and amikacin were found to be sensitive. Only 38% of isolates were sensitive to ampicillin. Empiric ceftriaxone therapy was used in 70% of the cases. The average length of parenteral therapy was 3.8 days. Based on the results of this study, the following recommendations were made: blood cultures should be obtained in all patients; the use of ampicillin alone should be avoided due to the drug's poor activity against isolated urinary pathogens; and ceftriaxone should be used for empiric therapy in the majority of patients, including diabetics, due to the drug's excellent activity against isolated urinary pathogens.
Coley
A L
AL
Department of Pharmacy, University Medical Center, Jacksonville, FL.
Todd
M W
MW
Harrington
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use*; D005260:Female; D005431:Florida; D006746:Hospital Bed Capacity, 500 and over; D006784:Hospitals, Teaching / Q000592:standards*; D006785:Hospitals, University / Q000592:standards*; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D011247:Pregnancy; D012189:Retrospective Studies; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology
D000900:Anti-Bacterial Agents; D002443:Ceftriaxone