Conway et al identified risk factors for antibiotic resistance in a recurrent urinary tract infection affecting a young child. These can help identify a patient who may benefit from more aggressive management. The authors are from the University of Pennsylvania, Children's Hospital of Philadelphia and Cincinnati Children's Hospital.
Patient selection: <= 6 years of age with a urinary tract infection (UTI)
Outcome: bacterial isolate resistant to 1 or more antibiotics
Parameters:
(1) race of the patient
(2) age in years
(3) vesicoureteral reflux (VUR)
(4) antibiotic prophylaxis
|
Race |
Age |
VUR |
Prophylaxis |
Rate Any Resistance |
|
nonwhite |
2 to 6 |
yes |
yes |
97% |
|
nonwhite |
2 to 6 |
yes |
no |
90% |
|
nonwhite |
2 to 6 |
no |
yes |
92% |
|
nonwhite |
2 to 6 |
no |
no |
74% |
|
nonwhite |
0 or 1 |
yes |
yes |
98% |
|
nonwhite |
0 or 1 |
yes |
no |
92% |
|
nonwhite |
0 or 1 |
no |
yes |
94% |
|
nonwhite |
0 or 1 |
no |
no |
80% |
|
white |
2 to 6 |
yes |
yes |
89% |
|
white |
2 to 6 |
yes |
no |
67% |
|
white |
2 to 6 |
no |
yes |
73% |
|
white |
2 to 6 |
no |
no |
40% |
|
white |
0 or 1 |
yes |
yes |
89% |
|
white |
0 or 1 |
yes |
no |
75% |
|
white |
0 or 1 |
no |
yes |
80% |
|
white |
0 or 1 |
no |
no |
49% |
A patient who is at high risk for a resistant organism should be treated more aggressively.
Specialty: Infectious Diseases, Pharmacology, clinical
ICD-10: ,
