Is it acceptable to select antibiotics for the treatment of community-acquired acute cystitis based on the antibiotics susceptibility results for uropathogens from community-acquired acute pyelonephritis in Korea?

Bongyoung Kim, Jieun Kim, Seong Heon Wie, Sun Hee Park, Young Kyun Cho, Seung Kwan Lim, Sang Yop Shin, Joon Sup Yum, Jin Seo Lee, Ki Tae Kweon, Hyuck Lee, Hee-Jin Cheong, Dae Won Park, Seong Yeol Ryu, Moon Hyun Chung, Hyunjoo Pai

Research output: Contribution to journalArticle

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Abstract

Background: Uncomplicated acute cystitis (CA-UAC) is one of the most common infections treated with antibiotics in the community. However, few data on etiology of CA-UAC and its susceptibility to antibiotics are available, primarily because, in Korea, insurance does not allow reimbursement for microbiological evaluation of CA-UAC. However, microbiologic data on community-acquired uncomplicated acute pyelonephritis (CA-UAPN) are available. The objective of the study was to evaluate the question of whether microbiologic data on CA-UAPN can be used for treatment of CA-UAC; therefore, etiology and antimicrobial susceptibility were compared between pathogens of CA-UAC and those of CA-UAPN. Materials and Methods: During 2008, 538 CA-UACs and 1,265 CA-UAPNs were recruited retrospectively from 14 hospitals (UTI research group). Microbiologic data on etiology and susceptibility to antibiotics were collected retrospectively. Results: Urine culture was positive in 131 CA-UACs (131/469, 27.9%) and 719 CA-UAPNs (719/1249, 57.6%). Escherichia coli was the most common pathogen in both groups [83.2% (109/131) in CA-UAC vs. 91.9% (661/719) in CA-UAPN]. Susceptibility to common UTI regimens, such as ciprofloxacin, extended-spectrum cephalosporins, and trimethoprim/sulfamethoxazole did not differ between urinary pathogens of CA-UACs and CA-UAPNs, however, a significant difference was observed in rates of resistance to ampicillin/sulbactam (16.5% vs. 42.9%, P<0.001, respectively). Conclusions: Rates of resistance of E. coli from CA-UAC and CA-UAPN to most antibiotics did not differ. For proper treatment, further microbiological evaluation for CA-UAC is mandatory.

Original languageEnglish
Pages (from-to)269-274
Number of pages6
JournalInfection and Chemotherapy
Volume44
Issue number4
DOIs
Publication statusPublished - 2012 Aug 1

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Cystitis
Pyelonephritis
Korea
Anti-Bacterial Agents
Escherichia coli
Sulfamethoxazole Drug Combination Trimethoprim
Cephalosporins
Ciprofloxacin
Insurance
Urine
Infection
Research

Keywords

  • Antibiotic
  • Community
  • Cystitis
  • Pyelonephritis
  • Resistance

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Is it acceptable to select antibiotics for the treatment of community-acquired acute cystitis based on the antibiotics susceptibility results for uropathogens from community-acquired acute pyelonephritis in Korea? / Kim, Bongyoung; Kim, Jieun; Wie, Seong Heon; Park, Sun Hee; Cho, Young Kyun; Lim, Seung Kwan; Shin, Sang Yop; Yum, Joon Sup; Lee, Jin Seo; Kweon, Ki Tae; Lee, Hyuck; Cheong, Hee-Jin; Park, Dae Won; Ryu, Seong Yeol; Chung, Moon Hyun; Pai, Hyunjoo.

In: Infection and Chemotherapy, Vol. 44, No. 4, 01.08.2012, p. 269-274.

Research output: Contribution to journalArticle

Kim, Bongyoung ; Kim, Jieun ; Wie, Seong Heon ; Park, Sun Hee ; Cho, Young Kyun ; Lim, Seung Kwan ; Shin, Sang Yop ; Yum, Joon Sup ; Lee, Jin Seo ; Kweon, Ki Tae ; Lee, Hyuck ; Cheong, Hee-Jin ; Park, Dae Won ; Ryu, Seong Yeol ; Chung, Moon Hyun ; Pai, Hyunjoo. / Is it acceptable to select antibiotics for the treatment of community-acquired acute cystitis based on the antibiotics susceptibility results for uropathogens from community-acquired acute pyelonephritis in Korea?. In: Infection and Chemotherapy. 2012 ; Vol. 44, No. 4. pp. 269-274.
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abstract = "Background: Uncomplicated acute cystitis (CA-UAC) is one of the most common infections treated with antibiotics in the community. However, few data on etiology of CA-UAC and its susceptibility to antibiotics are available, primarily because, in Korea, insurance does not allow reimbursement for microbiological evaluation of CA-UAC. However, microbiologic data on community-acquired uncomplicated acute pyelonephritis (CA-UAPN) are available. The objective of the study was to evaluate the question of whether microbiologic data on CA-UAPN can be used for treatment of CA-UAC; therefore, etiology and antimicrobial susceptibility were compared between pathogens of CA-UAC and those of CA-UAPN. Materials and Methods: During 2008, 538 CA-UACs and 1,265 CA-UAPNs were recruited retrospectively from 14 hospitals (UTI research group). Microbiologic data on etiology and susceptibility to antibiotics were collected retrospectively. Results: Urine culture was positive in 131 CA-UACs (131/469, 27.9{\%}) and 719 CA-UAPNs (719/1249, 57.6{\%}). Escherichia coli was the most common pathogen in both groups [83.2{\%} (109/131) in CA-UAC vs. 91.9{\%} (661/719) in CA-UAPN]. Susceptibility to common UTI regimens, such as ciprofloxacin, extended-spectrum cephalosporins, and trimethoprim/sulfamethoxazole did not differ between urinary pathogens of CA-UACs and CA-UAPNs, however, a significant difference was observed in rates of resistance to ampicillin/sulbactam (16.5{\%} vs. 42.9{\%}, P<0.001, respectively). Conclusions: Rates of resistance of E. coli from CA-UAC and CA-UAPN to most antibiotics did not differ. For proper treatment, further microbiological evaluation for CA-UAC is mandatory.",
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author = "Bongyoung Kim and Jieun Kim and Wie, {Seong Heon} and Park, {Sun Hee} and Cho, {Young Kyun} and Lim, {Seung Kwan} and Shin, {Sang Yop} and Yum, {Joon Sup} and Lee, {Jin Seo} and Kweon, {Ki Tae} and Hyuck Lee and Hee-Jin Cheong and Park, {Dae Won} and Ryu, {Seong Yeol} and Chung, {Moon Hyun} and Hyunjoo Pai",
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T1 - Is it acceptable to select antibiotics for the treatment of community-acquired acute cystitis based on the antibiotics susceptibility results for uropathogens from community-acquired acute pyelonephritis in Korea?

AU - Kim, Bongyoung

AU - Kim, Jieun

AU - Wie, Seong Heon

AU - Park, Sun Hee

AU - Cho, Young Kyun

AU - Lim, Seung Kwan

AU - Shin, Sang Yop

AU - Yum, Joon Sup

AU - Lee, Jin Seo

AU - Kweon, Ki Tae

AU - Lee, Hyuck

AU - Cheong, Hee-Jin

AU - Park, Dae Won

AU - Ryu, Seong Yeol

AU - Chung, Moon Hyun

AU - Pai, Hyunjoo

PY - 2012/8/1

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N2 - Background: Uncomplicated acute cystitis (CA-UAC) is one of the most common infections treated with antibiotics in the community. However, few data on etiology of CA-UAC and its susceptibility to antibiotics are available, primarily because, in Korea, insurance does not allow reimbursement for microbiological evaluation of CA-UAC. However, microbiologic data on community-acquired uncomplicated acute pyelonephritis (CA-UAPN) are available. The objective of the study was to evaluate the question of whether microbiologic data on CA-UAPN can be used for treatment of CA-UAC; therefore, etiology and antimicrobial susceptibility were compared between pathogens of CA-UAC and those of CA-UAPN. Materials and Methods: During 2008, 538 CA-UACs and 1,265 CA-UAPNs were recruited retrospectively from 14 hospitals (UTI research group). Microbiologic data on etiology and susceptibility to antibiotics were collected retrospectively. Results: Urine culture was positive in 131 CA-UACs (131/469, 27.9%) and 719 CA-UAPNs (719/1249, 57.6%). Escherichia coli was the most common pathogen in both groups [83.2% (109/131) in CA-UAC vs. 91.9% (661/719) in CA-UAPN]. Susceptibility to common UTI regimens, such as ciprofloxacin, extended-spectrum cephalosporins, and trimethoprim/sulfamethoxazole did not differ between urinary pathogens of CA-UACs and CA-UAPNs, however, a significant difference was observed in rates of resistance to ampicillin/sulbactam (16.5% vs. 42.9%, P<0.001, respectively). Conclusions: Rates of resistance of E. coli from CA-UAC and CA-UAPN to most antibiotics did not differ. For proper treatment, further microbiological evaluation for CA-UAC is mandatory.

AB - Background: Uncomplicated acute cystitis (CA-UAC) is one of the most common infections treated with antibiotics in the community. However, few data on etiology of CA-UAC and its susceptibility to antibiotics are available, primarily because, in Korea, insurance does not allow reimbursement for microbiological evaluation of CA-UAC. However, microbiologic data on community-acquired uncomplicated acute pyelonephritis (CA-UAPN) are available. The objective of the study was to evaluate the question of whether microbiologic data on CA-UAPN can be used for treatment of CA-UAC; therefore, etiology and antimicrobial susceptibility were compared between pathogens of CA-UAC and those of CA-UAPN. Materials and Methods: During 2008, 538 CA-UACs and 1,265 CA-UAPNs were recruited retrospectively from 14 hospitals (UTI research group). Microbiologic data on etiology and susceptibility to antibiotics were collected retrospectively. Results: Urine culture was positive in 131 CA-UACs (131/469, 27.9%) and 719 CA-UAPNs (719/1249, 57.6%). Escherichia coli was the most common pathogen in both groups [83.2% (109/131) in CA-UAC vs. 91.9% (661/719) in CA-UAPN]. Susceptibility to common UTI regimens, such as ciprofloxacin, extended-spectrum cephalosporins, and trimethoprim/sulfamethoxazole did not differ between urinary pathogens of CA-UACs and CA-UAPNs, however, a significant difference was observed in rates of resistance to ampicillin/sulbactam (16.5% vs. 42.9%, P<0.001, respectively). Conclusions: Rates of resistance of E. coli from CA-UAC and CA-UAPN to most antibiotics did not differ. For proper treatment, further microbiological evaluation for CA-UAC is mandatory.

KW - Antibiotic

KW - Community

KW - Cystitis

KW - Pyelonephritis

KW - Resistance

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