title: Role of age and sex in determining antibiotic resistance in febrile urinary tract infections.
abstract: OBJECTIVE
  To identify the age- and sex-specific antimicrobial susceptibility patterns of Gram-negative bacteria (GNB) in outpatient febrile urinary tract infections (UTIs) in Korea.
  
  
  METHODS
  A total 2262 consecutive samples collected from patients aged 1-101 years with febrile UTIs, during the period January 2012 to December 2014, were analyzed in this multicentre, retrospective cohort study.
  
  
  RESULTS
  The sensitivities to cefotaxime and cefoxitin were over 85% for females but under 75% for males. Sex played an important role in the susceptibility of GNB to cefotaxime (p<0.001) and cefoxitin (p<0.001). The sensitivity to ciprofloxacin (age >20 years) was under 75% in both sexes, and was not influenced by sex (p=0.204). Age distributions of the incidences of resistance to cefotaxime, cefoxitin, and ciprofloxacin (age >20 years) were similar to the age distribution of the incidence of GNB, which indicates that the resistance patterns to these drugs were not affected by age (Kolmogorov-Smirnov test, female/male: p=0.927/p=0.509, p=0.193/p=0.911, and p=0.077/p=0.999, respectively).
  
  
  CONCLUSIONS
  Age is not a considerable factor in determining the antibiotic resistance in febrile UTIs. Ciprofloxacin should be withheld from both sexes until culture results indicate its use. Second- or third-generation cephalosporins such as cefoxitin and cefotaxime can be used empirically only in females.
authors: Department of Urology, St. Vincent's Hospital, The Catholic University of Korea, College of Medicine, 93-6 Ji-dong Paldal-gu, Suwon 442-723, Korea.
authors: Dong Sup
authors: DS
authors: Lee
authors: Department of Urology, St. Vincent's Hospital, The Catholic University of Korea, College of Medicine, 93-6 Ji-dong Paldal-gu, Suwon 442-723, Korea.
authors: Hyun-Sop
authors: HS
authors: Choe
authors: Department of Urology, St. Vincent's Hospital, The Catholic University of Korea, College of Medicine, 93-6 Ji-dong Paldal-gu, Suwon 442-723, Korea.
authors: Hee Youn
authors: HY
authors: Kim
authors: Department of Urology, St. Vincent's Hospital, The Catholic University of Korea, College of Medicine, 93-6 Ji-dong Paldal-gu, Suwon 442-723, Korea.
authors: Je Mo
authors: JM
authors: Yoo
authors: Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea.
authors: Woong Jin
authors: WJ
authors: Bae
authors: Department of Urology, Yeouido St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea.
authors: Yong Hyun
authors: YH
authors: Cho
authors: Department of Urology, Yeouido St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea.
authors: Sun Wook
authors: SW
authors: Kim
authors: Department of Urology, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Uijeongbu, Korea.
authors: Chang Hee
authors: CH
authors: Han
authors: Department of Urology, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Uijeongbu, Korea.
authors: Sang Rak
authors: SR
authors: Bae
authors: Department of Urology, Daejeon St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Daejeon, Korea.
authors: Hoon
authors: H
authors: Jang
authors: Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan, Korea.
authors: Su Bum
authors: SB
authors: Park
authors: International St. Mary's Hospital, Catholic Kwandong University, Incheon, South Korea.
authors: Byung Il
authors: BI
authors: Yoon
authors: Department of Urology, St. Vincent's Hospital, The Catholic University of Korea, College of Medicine, 93-6 Ji-dong Paldal-gu, Suwon 442-723, Korea. Electronic address: lee.seungju@gmail.com.
authors: Seung-Ju
authors: SJ
authors: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002439:Cefotaxime / Q000494:pharmacology; D002440:Cefoxitin / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D002939:Ciprofloxacin / Q000494:pharmacology / Q000627:therapeutic use; D015331:Cohort Studies; D024881:Drug Resistance, Bacterial; D005334:Fever; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012737:Sex Factors; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D002440:Cefoxitin; D019980:Amoxicillin-Potassium Clavulanate Combination; D002439:Cefotaxime
keywords: Age distribution; Antimicrobial susceptibility; Cephalosporins; Ciprofloxacin; Sex