[Empirical treatment of urinary tract infections in the delivery room--findings and desires].
Urinary tract infection (UTI) is the most common bacterial infection during pregnancy. In prenatal and delivery wards treatment is usually started at once in pregnant women with symptoms suggesting UTI, but there is no uniformity as to treatment. We surveyed such treatment in the delivery rooms throughout Israel, and whether the treatment differed in simple cystitis as opposed to pyelonephritis. Results of positive urine cultures from symptomatic parturients admitted here during 1995-1996 were examined. There were 17 different empiric treatment protocols in 28 delivery rooms, whose daily cost ranged from 1-119 NIS. We present the antimicrobial sensitivity of 156 bacteria isolated from the urinary cultures from pregnant women in our prenatal ward. Based upon urinary flora, sensitivity and daily cost, we suggest a protocol for empiric treatment. We recommend first and second generation cephalosporins for treatment of simple lower (UTIs), while gentamicin is suggested for treatment of clinical pyelonephritis during pregnancy. There is no medical nor economic justification for the multiplicity of empiric treatment protocols currently used. Considering our results, our protocol is cost-effective for the empiric treatment of UTI in hospitalized parturients and in the community as well.
Obstetrics and Gynecology Dept., Rambam Medical Center, Haifa.
P
P
Jakobi
O
O
Goldstick
R
R
Finkelstein
J
J
Itzkovitz-Eldor
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000145:classification / Q000188:drug therapy*; D002511:Cephalosporins / Q000627:therapeutic use; D003696:Delivery Rooms; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use; D019538:Health Care Surveys; D006801:Humans; D007557:Israel; D007744:Obstetric Labor Complications / Q000188:drug therapy* / Q000382:microbiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D011704:Pyelonephritis / Q000188:drug therapy; D014552:Urinary Tract Infections / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D005839:Gentamicins