Resistance profiles of urinary tract infections in general practice - an observational study

In a prospective, multi-center observational study general practitioner included all female patients？≥？18 years with clinically suspected urinary tract infection. Only patients receiving an antibiotic therapy within the last two weeks were excluded.40 practices recruited 191 female patients (mean age 52 years; range 18–96) with urinary tract infections. Main causative agent was Escherichia coli (79%) followed by Enterococcus faecalis (14%) and Klebsiella pneumoniae (7.3%).Susceptibiliy of E.coli as the main causative agent was highest against fosfomycin and nitrofurantoin, with low resistance rates of 4,5%; 2,2%. In 17,5%, E.coli was resistant to trimethoprim and in 8,5% to ciprofloxacin.Resistance rates of uropathogens from unselected patients in general practice differ from routinely collected laboratory data. These results can have an impact on antibiotic prescribing and treatment recommendations.Antibiotic resistance is an emerging and serious public health problem resulting in increased morbidity and mortality. In urinary tract infections (UTI), resistance rates against commonly prescribed antimicrobial agents are constantly rising. Nowadays, in many countries more than 20% of responsible uropathogens are resistant to trimethoprim /sulfamethoxazole (tmp-smx) and to cephalosporins. This increasing resistance is also being observed for fluoroquinolones with resistance rates, risen up to 10% [1,2]. As medicine faces a bleak outlook on availability of effective antibiotic treatment, new therapeutic strategies for urinary tract infections are necessary.In 2011 an action plan has been launched by the European Commission [3] to tackle these problems. Aims and strategies include the promotion of a restrictive and appropriate use of antibiotics as well as the promotion of national surveillance programs. To optimize antibiotic treatment of uncomplicated UTI, the latter is urgently required for several reasons:●？Although the majority of antibiotic prescribing for uncompli