title: Antibiotic resistance in urinary tract infections in college students.
abstract: OBJECTIVE
  To determine resistance to antibiotics of Escherichia coli in uncomplicated urinary tract infections (uUTIs) in female college students.
  
  
  METHODS
  Symptomatic patients presenting to a student health service from September 2008 to December 2009.
  
  
  METHODS
  Clean catch midstream urine samples were tested for urinalysis (UA) and culture and sensitivity.
  
  
  RESULTS
  Of 168 students enrolled in the study, 138 had positive UA, and 94 of these grew >100,000 colonies/mL of E. coli. Ampicillin resistance was 31.9%, trimethoprim-sulfamethoxazole (TMP-SMX) resistance 16.0%, ciprofloxacin resistance 4.3%, amoxicillin/clavulanate resistance 3.2%, and nitrofurantoin resistance 1.1%. The sensitivity of UA was 95.4% and the positive predictive value was 87.0% (p ≤ .001). Specificity was 77.5% and negative predictive value 92.9%.
  
  
  CONCLUSIONS
  In healthy college women with uUTI symptoms, TMP-SMX should not be universally used for empirical therapy, whereas use of ciprofloxacin, amoxicillin/clavulanate, and nitrofurantoin are appropriate.
authors.affiliation: Duke University Health Service, Duke University, Durham, North Carolina 27710, USA. ron.olson@duke.edu
authors.forename: Ronald P
authors.initials: RP
authors.lastname: Olson
authors.forename: Karen
authors.initials: K
authors.lastname: Haith
mesh_terms: D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000892:Anti-Infective Agents, Urinary / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000627:therapeutic use; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D009582:Nitrofurantoin / Q000627:therapeutic use; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013334:Students; D014495:Universities; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000453:epidemiology*; D016387:Women's Health; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000892:Anti-Infective Agents, Urinary; D002939:Ciprofloxacin; D019980:Amoxicillin-Potassium Clavulanate Combination; D009582:Nitrofurantoin