title: Adult and Pediatric Intra-Institutional Trends of Ciprofloxacin Susceptibility in E. coli Positive Urinary Cultures.
abstract: Antimicrobial drug resistance in treatment of urinary tract infection (UTI) continues to rise worldwide. To examine contributions of physician prescribing patterns to fluoroquinolone (ciprofloxacin, CP) resistance, we examined Escherichia coli (E. coli) resistance patterns in urinary cultures. Since CP usage is limited in children, we compared CP resistance trends in adults and children to those of more commonly used trimethoprim-sulfamethoxazole (TMP-SMX) and nitrofurantoin (NF). Our data show that although the general pediatric population has lower resistance to ciprofloxacin, resistance levels are rising with increased usage. While NF susceptibility is historically stable, TMP-SMX resistance is slightly higher in children compared to adults. In both adults and children, antimicrobial resistance patterns vary according to clinical practice site, with ambulatory urology patients showing the highest resistance. This suggests that physician's prescribing patterns contribute to antimicrobial resistance.
authors.affiliation: Department of Urology, Stanford University Medical Center, 750 Welch Rd, MC: 5725, Stanford, CA 94305-5725, USA. isi@stanford.edu.
authors.forename: Winifred
authors.initials: W
authors.lastname: Owumi
authors.affiliation: Departments of Pathology and Medicine, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA 94304, USA. niazbanaei@stanford.edu.
authors.forename: Niaz
authors.initials: N
authors.lastname: Banaei
authors.affiliation: Department of Urology, Stanford University Medical Center, 750 Welch Rd, MC: 5725, Stanford, CA 94305-5725, USA. lindashortliffe@stanford.edu.
authors.forename: Linda D
authors.initials: LD
authors.lastname: Shortliffe
keywords: E. coli; bacterial resistance; ciprofloxacin; nitrofurantoin; susceptibility; trimethoprim-sulfamethoxazole; urinary cultures; urinary tract infection