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Published on: June 23, 2015
Antibiotic resistance in urinary tract infections in college students
1Duke University Health Service, Duke University, Durham, North Carolina 27710, USA. ron.olson@duke.edu
Objective:
To determine resistance to antibiotics of Escherichia coli in uncomplicated urinary tract infections (uUTIs) in female college students.
Participants:
Symptomatic patients presenting to a student health service from September 2008 to December 2009.
Methods:
Clean catch midstream urine samples were tested for urinalysis (UA) and culture and sensitivity.
Results:
Of 168 students enrolled in the study, 138 had positive UA, and 94 of these grew >100,000 colonies/mL of E. coli. Ampicillin resistance was 31.9%, trimethoprim-sulfamethoxazole (TMP-SMX) resistance 16.0%, ciprofloxacin resistance 4.3%, amoxicillin/clavulanate resistance 3.2%, and nitrofurantoin resistance 1.1%. The sensitivity of UA was 95.4% and the positive predictive value was 87.0% (p ≤ .001). Specificity was 77.5% and negative predictive value 92.9%.
Conclusions:
In healthy college women with uUTI symptoms, TMP-SMX should not be universally used for empirical therapy, whereas use of ciprofloxacin, amoxicillin/clavulanate, and nitrofurantoin are appropriate.
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