title: Co-trimoxazole and quinolone resistance in Escherichia coli isolated from urinary tract infections over the last 10 years.
abstract: Over the last 10 years the treatment of choice for urinary tract infections (UTIs) in Turkey has changed from co-trimoxazole to quinolones owing to the rate of resistance to co-trimoxazole and its high level of therapeutic failure. The resistance ratio of 1939 UTI Escherichia coli from outpatients (1994-2003) was evaluated by Kirby-Bauer disc diffusion method for the aforementioned antibiotics to determine the change in resistance. The co-trimoxazole resistance ratio decreased during this period, with the highest ratio in 1996 (69.3%) and the lowest ratio in 2003 (38.5%) (P < 0.001). The lowest resistance ratios occurred in 1995 (4.1%) for ofloxacin and in 1996 (5.2%) for ciprofloxacin, and the highest resistance ratios occurred in 2002 (25.3% and 27.6%) for ofloxacin and ciprofloxacin, respectively (P < 0.001, P < 0.001). These findings emphasise that antibiotic usage policies, especially empirical therapies, should be based on antimicrobial resistance surveillance studies.
authors.affiliation: Refik Saydam National Hygiene Center, Communicable Diseases Research Department, Sihhiye, 06100 Ankara, Turkey.
authors.forename: Yilmaz
authors.initials: Y
authors.lastname: Karaca
authors.forename: Nilay
authors.initials: N
authors.lastname: Coplu
authors.forename: Aysegül
authors.initials: A
authors.lastname: Gozalan
authors.forename: Ozgur
authors.initials: O
authors.lastname: Oncul
authors.forename: Burak E
authors.initials: BE
authors.lastname: Citil
authors.forename: Berrin
authors.initials: B
authors.lastname: Esen
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D004927:Escherichia coli Infections / Q000188:drug therapy* / Q000453:epidemiology; D024841:Fluoroquinolones / Q000494:pharmacology*; D006801:Humans; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology*; D014421:Turkey / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D015662:Trimethoprim, Sulfamethoxazole Drug Combination