SUSCEPTIBILITY PATTERNS AND CLINICAL MANAGEMENT OF HOSPITALISED CHILDREN WITH URINARY TRACT INFECTIONS IN CENTRAL GREECE

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BackgroundThe aim of this study was to describe antibiotic prescribing patterns and evaluate resistant rates in hospitalised children with febrile and afebrile UTIs in a district hospital in central Greece.MethodsData was collected retrospectively, including information on antibiograms and antibiotic prescriptions. Patients were included based on clinical and microbiological criteria, while sensitivity to antimicrobials was determined using the Kirby-Bauer disk diffusion method.ResultsTwo hundred thirty patients were included in the study. Among 459 prescriptions identified, amikacin (31.2%) was the most common antibiotic prescribed in this population. The following most common antibiotics were amoxicillin-clavulanic acid (17.4%) and ampicillin (13.5%). Children received prolonged intravenous treatments for febrile (5.4 days; SD 1.45) and afebrile UTIs (4.7 days; SD 1.34). A total of 236 pathogens were isolated. The main causative organism was Escherichia coli (79.2%) with high reported resistance rates to ampicillin (42.0%), trimethoprim-sulfamethoxazole (26.5%) and amoxicillin/clavulanic acid (12.2%). Lower resistance rates were identified for 3rd generation cephalosporins (1.7%), nitrofurantoin (2.3%), ciprofloxacin (1.3%) and amikacin (0.9%). Klebsiella spp. isolates were highly resistant to cefaclor (27.3%).ConclusionThe establishment of antimicrobial stewardship programs could help to minimise inappropriate prescribing for UTIs in Greek hospitals. UTIs is a key area to monitor antimicrobial resistance in childhood.

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