Approaches to antibiotic therapy in patients with calculous pyelonephritis, undergoing in-patient treatment in the department of urology

Abstract

Urolithiasis is one of the most common urologic diseases and it is found more than 3% of the population of Russia, which is complicated by calculous pyelonephritis from 43-81% up to 100% of cases. The knowledge of the main bacteria usually involved in patients with calculous pyelonephritis and their antimicrobial susceptibility is necessary for appropriate empirical therapy and prevention of the emergence of antibiotic resistance. The main pathogens in patients with calculous pyelonephritis undergoing treatment in the department of urology of St. Joseph Belgorod Regional Clinical Hospital in 2013-2015 was Escherichia coli, was presented in 36.8% of the isolates, followed by Klebsiella species in 18.1% of the isolates, Enterobacter species in 16.9% of the isolates, and Proteus species in 8.8% of the isolates. All isolates showed susceptibilities to carbapenems. Sensitivity to cephalosporins ranged from 48.5% of the cases to 41.8% of the cases, to fluoroquinolones from 32.4% of the cases to 24.5% of the cases, to co-trimoxazole ranged from 27.9% of the cases to 30.84% of the cases in 2013-2015. It was found increase of aminoglycosides activity: sensitive strains to amikacin were allocated 67.6% of the isolates, 86.1% of the isolates, 84.7% of the isolates, it was identified sensitive strains to gentamicin in 44.3% of the isolates, 53.5% of the isolates, 55.2% of the isolates in 2013, 2014, 2015, respectively. High effective agents was fosfomycin, which shown activity in 79.3% of the cases, 84.4% of the cases, 80.4% of the cases in 2013, 2014, 2015, respectively. The obtained data were shown, that amikacin, fosfomycin, piperacillin/tazobactam, cefoperazone/sulbactam, carbapenems can be used for empirical therapy in patients with calculous pyelonephritis undergoing treatment in the department of urology of St. Joseph Belgorod Regional Clinical Hospital.