ANTIBIOTIC RESISTANCE PATTERNS AND EVALUATION OF TREATMENT IN OUT-PATIENTS WITH URINARY TRACT INFECTIONS IN NEPAL

The study was aimed to investigate the common causative agents of urinary tract infection in community, their resistance pattern to different antibiotics, and the prescribing patterns of antibiotics used for treatment. A total of 200 women attending gynaecology OPD of Tribhuvan University teaching hospital had their urine tested for culture and sensitivity, out of which 85 showed microbial growths. Escherichia coli (56.9%) and Staphylococcus aureus (27.7%) were the most common organisms isolated. E.coli was found to be resistant against ampicillin (72.7%), followed bycephalexin (59.3%), cotrimoxazole (45.2%), cefixime (40%), ceftriaxone (26.3%), norfloxacin (25.9), ciprofloxacin (25%), ofloxacin (20.7%) nitrofurantoin(9.7%), gentamycin (9.4%) and amikacin (8%). S.aureus was found to be resistant against cefixime (71.4%), followed by ampicillin (64.7%), ciprofloxacin (60%), cotrimoxazole (35.7%), ofloxacin (33.3%), norfloxacin (33.3%), cephalexin (23.5%), cloxacillin (17.6%), gentamycin (8.3%) and nitrofurantoin (5.9%). Out of 65 patients, 48 were treated with definite antibiotic therapy and 17 were treated with empirical antibiotics. The antibiotics used in definite therapy were nitrofurantoin (36.7%), ofloxacin (20.4%), cephalexin (10.2%), norfloxacin (8.2%), ciprofloxacin (8.2%), cloxacillin (4.1%), cefixime (4.1%), ampicillin (4.1%), amikacin (2%) and levofloxacin (2%). The antibiotics used in empirical treatment were nitrofuran to in (35.2%), ofloxacin (29.4%), cefixime (11.7%), norfloxacin (11.7%), amoxicillin (5.8%), and levofloxacin (5.8%).