| Causative Organisms and Antibiotics Sensitivity in Community Acquired Acute Pyelonephritis |
| Hajeong Lee, M.D.2, Hayne Cho Park, M.D.2, Hyun-Bae Yoon, M.D.2, Seung Seok Han, M.D.2, Cha Ran-hui, M.D.2, Kook-Hwan Oh, M.D.2, Kwon Wook Joo, M.D.2, Sang Won Park, M.D.1, Chun Soo, Lim, M.D.1, Yun Kyu Oh, M.D.1 |
Department of Internal Medicine1
Seoul National University Boramae Hospital, Department of Internal Medicine2
Seoul National University college of Medicine, Seoul, Korea |
| 임상연구 : 지역사회 획득 급성 신우신염의 원인균 및 ciprofloxacin 저항성에 대한 연구 |
| 이하정2, 박혜인조2, 윤현배2, 한승석2, 차란희2, 오국환2, 주권욱2, 박상원1, 임춘수1, 오윤규1 |
| 서울대학교 보라매병원 내과1, 서울대학교 의과대학 내과학교실2 |
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| Abstract |
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Purpose : Ciprofloxacin has been used as one of choice antibiotics for the empirical treatment of community-acquired acute pyelonephritis (APN), of which E-coli is the main causative bacterium. Recently, however, some studies show that ciprofloxacin-resistant E.coli is increasing in APN. In this study, authors aimed to re-evaluate ciprofloxacin as one of initial antibiotics for APN according to the survey of the patients' clinical and microbiologic characteristics.
Method : In this single center, the records of patients diagnosed as APN were reviewed retrospectively who visited emergency room or out-patient clinic from Aug. 01, 2005 to Jul. 31, 2007.
Result : A total of 303 patients were enrolled. The proportion of males to females was 1:9.4, the average age was 49.3±19 years old. Complicated APNs were 121 out of 303 patients, diabetes ranked highest, 52.5% (64/121). According to the urine culture analysis, the patients with isolated microorganism reached up to 45.2% (137/303) and E.coli occupied 94.2% out of total. As the initial antibiotics, ciprofloxacin was most commonly used (64.4%, 195/303), next was the 3rd generation cephalosporin (23.8%, 72/303). The analysis of antibiotics sensitivity demonstrated ciprofloxacin susceptibility was 81.4%, whereas high over 90% in the 3rd generation cephalosporin. When the ciprofloxacin-resistant E.coli was isolated, the patients tended to have prolonged duration of antibiotics treatment, a higher proportion of complicated APNs and of treatment non-responders.
Conclusion : For the APNs, ciprofloxacin is clinically effective initial antibiotics; however, it should be carefully used especially in case of the patients having combined underlying disease or the aged.
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| Key Words:
Pyelonephritis, E.coli, Ciprofloxacin resistance |
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