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KMID : 0984720030350050277
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Infection and Chemotherapy
2003 Volume.35 No. 5 p.277 ~ p.282
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Antimicrobial Susceptibility of Causative Microorganisms in Adults with Acute Pyelonephritis at One University-Affiliated Hospital in Southwestern Seoul
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Hwang Byung-Yeon
Lee Jae-Gap
Park Dae-Won
Lee Yeon-Joo
Kim Sung-Bum
Eom Joong-Sik
Sohn Jang-Wook
Cheong Hee-Jin
Kim Woo-Joo
Kim Min-Ja
Park Seung-Chul
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Abstract
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Background : The purpose of this study is to recommend the initial therapeutic regimen for adult patients with acute pyelonephritis (APN) according to the changes of antimicrobial susceptibility patterns of causative microorganisms isolated from patients with APN.
Methods : We reviewed medical charts of 229 APN patients, who had been treated at Korea University Guro Hospital from 1st of January, 1999 to 31st of December, 2001. We investigated the demo-graphic data, clinical findings, durations of hospital treatment, antimicrobial susceptibility patterns of the causative microorganisms and initial antibiotic regimens in patients with APN.
Results : In this study, 229 adult patients with APN were classified into simple APN patients (118 patients, 51.5%) and complicated APN patients (111 patients, 48.4%). Mean age of patients with simple APN was 38.214.1 years old and that of patients with complicated APN was 56.1 14.9 years old. Mean age of patients with complicated APN was significantly higher than that of simple APN patients (P<0.0001). Escherichia coli was the most common microorganism both in simple APN (96.7%) group and in complicated APN (90.6%) group. Antimicrobial susceptibility of E. coli was at the low level of ampicillin (31%/20%) and trimethoprimsulfamethoxazole (42.6%/34.2%) in each group. In contrast, ciprofloxacin (11.5%/22.7%), gentamicin (16.4%/22%) and cefotaxime (0%/8.2%) resistance remained at relatively lower level. In comparison of simple APN with complicated APN, ciprofloxacin and gentarnicin resistances were higher in complicted APN group. Average duration of hospitalization (5.92.3 days/8.24.6 days) and duration of ant biotic use (12.13.9 days/15.310.0 days) were significantly longer in´ complicated APN.
Conclusions : The results of this study suggests that 3`d cephalosporin, aminoglycoside or quinolone antibiotic would considered as one of the initial therapeutic regimen for patients with simple APN in southwestern Seoul.
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KEYWORD
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Acute pyelonephritis, E. coli, Antimicrobial susceptibility, Initial therapeutic regimen
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