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Trimethoprim prescription and subsequent resistance in childhood urinary infection: multilevel modelling analysis

Mary A Duffy1, Virginia Hernandez-Santiago, Gillian Orange

  • 1Population Health Sciences Division, Medical Research Institute, University of Dundee, Dundee, UK.

The British Journal of General Practice : the Journal of the Royal College of General Practitioners
|April 2, 2013
PubMed

Insights

Previous trimethoprim prescriptions in children significantly increase the risk of trimethoprim-resistant E. coli infections. Recent antibiotic use is strongly linked to developing antibiotic resistance in pediatric urinary tract infections.

Area of Science:

  • Pediatric infectious diseases
  • Antimicrobial resistance
  • Public health

Background:

  • Antibiotic resistance is a significant global health threat.
  • Pediatric antibiotic use and resistance patterns are understudied.
  • Urinary tract infections (UTIs) are common in children.

Purpose of the Study:

  • To examine the link between prior trimethoprim prescribing and trimethoprim resistance in pediatric E. coli urinary isolates.
  • To understand the impact of antibiotic use on resistance development in children.

Main Methods:

  • Retrospective population cohort study in Tayside, Scotland (2004-2009).
  • Analysis of linked microbiology and dispensed prescribing data for 1373 children (≤16 years).
  • Multilevel modeling to assess the association between previous trimethoprim prescription and subsequent resistance.

Main Results:

  • Trimethoprim resistance in E. coli isolates was prevalent (26.6%).
  • Previous trimethoprim prescription was significantly associated with trimethoprim-resistant E. coli.
  • More recent trimethoprim prescriptions showed a stronger association with resistance.

Conclusions:

  • Trimethoprim prescribing directly impacts future resistance in pediatric UTIs.
  • Appropriate antibiotic selection and duration are crucial for children.
  • Consider alternative antibiotics for pediatric UTIs if trimethoprim was used recently.
Abstract

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