Role of age and sex in determining antibiotic resistance in febrile urinary tract infections

Abstract

Objectives: To identify the age- and sex-specific antimicrobial susceptibility patterns of Gram-negative bacteria (GNB) in outpatient febrile urinary tract infections (UTIs) in Korea. Methods: A total 2262 consecutive samples collected from patients aged 1–101 years with febrile UTIs, during the period January 2012 to December 2014, were analyzed in this multicentre, retrospective cohort study. Results: The sensitivities to cefotaxime and cefoxitin were over 85% for females but under 75% for males. Sex played an important role in the susceptibility of GNB to cefotaxime (p 20 years) was under 75% in both sexes, and was not influenced by sex (p = 0.204). Age distributions of the incidences of resistance to cefotaxime, cefoxitin, and ciprofloxacin (age >20 years) were similar to the age distribution of the incidence of GNB, which indicates that the resistance patterns to these drugs were not affected by age (Kolmogorov–Smirnov test, female/male: p = 0.927/p = 0.509, p = 0.193/p = 0.911, and p = 0.077/p = 0.999, respectively). Conclusions: Age is not a considerable factor in determining the antibiotic resistance in febrile UTIs. Ciprofloxacin should be withheld from both sexes until culture results indicate its use. Second- or third-generation cephalosporins such as cefoxitin and cefotaxime can be used empirically only in females.

Keywords

• Antimicrobial susceptibility
• Age distribution
• Sex
• Ciprofloxacin
• Cephalosporins