Background: Severe acute uncomplicated
pyelonephritis is an infection of the kidneys that usually have an ascending
route and occur in presumably healthy urinary tract. The most common pathogen
involved is E. coli. The Infectious
Diseases Society of America (IDSA) has issued an updated guideline in 2010
suggesting IV quinolones to be considered in the initial empiric antimicrobial
therapy giving known resistance of less than 10%. However, E. coli resistance to quinolones has been increasing, the recent
data of E. coli, causing
pyelonephritis, resistance is not known in the Midwest. Local hospital
antibiogram for two years showed up to 22% resistance to ciprofloxacin among E. coli isolates. Methods: We conduct a
retrospective non-concurrent cohort study in one teaching hospital in the
Midwest, females who were admitted with severe acute uncomplicated
pyelonephritis in a three years period were included. Patients with urinary
tract obstruction, pregnancy, immuno-suppression, males, and indwelling Foley’s
catheters were excluded. Data collected include causative pathogens and resistance
to antibiotics were collected. Percentages, frequencies, and measures of
central tendency and dispersion were calculated to describe the study sample Results:
73 patients were included in the final analysis. E. coli was the most common isolated pathogen (81%), followed by
other enteric gram negative. E. coli resistance to ciprofloxacin was 13.5%, 37% to trimethoprim-sulfamethoxazole,
and 5% to ceftriaxone. Conclusion: Ciprofloxacin should be avoided initially in
treating severe acute uncomplicated pyelonephritis until culture results and
sensitivity is available.
Cite this paper
Sitta, E. A. , Alhesan, N. A. , Kheiri, B. , Badami, S. , Elounais, F. , Assassa, O. , Gaddam, M. and Rios-Bedoya, C. (2017). Escherichia coli Resistance to Ciprofloxacin in Acute Uncomplicated Pyelonephritis. Open Access Library Journal, 4, e4043. doi: http://dx.doi.org/10.4236/oalib.1104043.
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