Infektološki glasnik, Vol. 30 No. 2, 2010.
Izvorni znanstveni članak
Empirical antimicrobial therapy of community-acquired urinary tract infections – the use of mathematical modelling in selecting a rational therapy
Vesna Mađarić
; Djelatnost za infektivne bolesti, Opća bolnica "Dr.T.Bardek", Koprivnica, Hrvatska
Nevenka Bujić
; Djelatnost za infektivne bolesti, Opća bolnica "Dr.T.Bardek", Koprivnica, Hrvatska
Gordana Kolaric-Sviben
; Djelatnost za infektivne bolesti, Opća bolnica "Dr.T.Bardek", Koprivnica, Hrvatska
Marta Urukalo
; Djelatnost za infektivne bolesti, Opća bolnica "Dr.T.Bardek", Koprivnica, Hrvatska
Vlatka Janeš-Poje
; Mikrobiološki laboratorij Zavoda za javno zdravstvo Koprivničko-križevačke županije, Koprivnica, Hrvatska
Vesna Dulikravić
; Mikrobiološki laboratorij Zavoda za javno zdravstvo Koprivničko-križevačke županije, Koprivnica, Hrvatska
Sažetak
The selection of initial empiric antibiotic therapy in the treatment of urinary tract infections (UTI) significantly affects the outcome of UTI.
An initial, empirical therapy should have a probability of more than 90% that the spectrum of administered antimicrobial drug will cover possible cause(s) of infection. The aim of this study is to show the importance of using a mathematical model-formula to help in the selection of the most potent, broad-spectrum antimicrobial agent in initial empirical antibiotic therapy based on local microbiological data, the incidence of pathogens and their sensitivity. In the two time periods, in 2003 and 2009 we analyzed medical records of 145, that is, 167 hospitalized patients treated for urinary tract infections. Based on local microbiological data on the incidence of pathogens and their sensitivity, using a mathematical model formula we acquired an insight into the potency of the most commonly used antibiotics in the initial empirical therapy. The highest proportion of strains isolated from urine was related to Escherichia coli and Klebsiella pneumoniae 70%/2003, 72%/2009, respectively. A mathematical model – formula has showed the capacity of antimicrobial agent as having the highest overall level of activity against main isolates from urine: amoxicillin/clavulanic acid (AMC) in the years 2003/2009: 80% / 77%, cefuroxime (CXM) 79%/69%, gentamicin (GM) 82% / 75%, ciprofloxacin (CIP) 81%/ 66%.
Statistically significant difference (p < 0.05) in reduced potency of empirical therapy was observed for ciprofloxacin in 2003 compared to 2009. Mathematical model-formula is a helping tool in choosing the initial empirical antimicrobial therapy in the treatment of urinary tract infections as well as in defining local antimicrobial guidelines for UTI.
Ključne riječi
Empirical antimicrobial therapy; mathematical model-formula
Hrčak ID:
59799
URI
Datum izdavanja:
30.6.2010.
Posjeta: 2.789 *