[Resistance of uropathogenic strains of Escherichia coli in pregnant women and other women in generative ages in comparison with antibiotics consumption in Zagreb].
OBJECTIVE
To compare resistance of uropathogenic strains of Escherichia coli (UPEC) to antibiotics in women in generative ages and pregnant women during two year period (2004 and 2008) in Zagreb, and comparison of resistance and the consumption of antibiotics.


METHODS
The standard disk-diffusion method was used for sensitivity testing to 16 different antibiotics. Data on antibiotic utilization were used to calculate the number of defined daily doses (DDD) and DDD per 1000 inhabitants using Anatomical-Therapeutic-Chemical/DDD methodology. Data on antibiotic consumption during pregnancy were collected using a questionnaire filled in by 893 women after delivery.


RESULTS
During 2004 resistance of UPEC to antimicrobial drugs was not different in pregnant and in non-pregnant women, with the exception of amoxicillin and nitrofurantoin, with statistically higher resistance in pregnant women (p < 0.01). Four years later the statistically higher resistance to norfloxacin was observed in non-pregnant women (p < 0.01). Comparing the resistance in 2004 and 2008, in the both groups of women a statistically significant decrease of resistance to cefalexin and nitrofurantoin was detected (p < 0.01). Outpatient utilization of antimicrobial drugs in Zagreb increased significantly, from 32 to 39 DDD/1000 inhabitants per day. The most used antibiotic was co-amoxiclav, and its utilization increased from 9.6 to 12.2 DDD/1000/day. Amoxicillin and co-amoxiclav were used during pregnancy by 9.6% interviewed women.


CONCLUSIONS
The observed significant decrease of resistance to cefalexin makes that antibiotic the drug of choice for treatment of urinary tract infections in women in generative ages, and together with coamoxiclav can be administered in pregnancy. Constant monitoring of urinary tract pathogens resistance to antimicrobial agents ensures the effectiveness of empirical therapy, whose versatile use is limited due the potentially harmful effects of antimicrobial drugs on fetus.
Culig
Josip
J
Referentni centar za farmakoepidemiologiju, Zavod za javno zdravstvo "Dr. Andrija Stampar", Zagreb, Hrvatska.
Mlinarić-Dzepina
Ana
A
Leppée
Marcel
M
Vranes
Jasmina
J
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D004363:Drug Utilization; D004926:Escherichia coli / Q000187:drug effects*; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D006801:Humans; D008826:Microbial Sensitivity Tests; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000382:microbiology*; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000382:microbiology*
D000900:Anti-Bacterial Agents