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J Korean Soc Emerg Med > Volume 33(5); 2022 > Article
Journal of The Korean Society of Emergency Medicine 2022;33(5): 480-486.
응급의료센터에서 진단된 급성 단순 방광염 환자의 항생제 내성률 및 적절한 항생제에 대한 고찰
정수용 , 김영식 , 정루비 , 이규현 , 유우성 , 윤영탁 , 최승주
분당제생병원 응급의학과
Acute uncomplicated cystitis in the emergency department: prevalence of antimicrobial resistance among uropathogens and appropriate antimicrobial treatment
Soo Young Chung , Youngsik Kim , Rubi Jeong , KyooHyun Lee , Woosung Yu , Youngtak Yoon , Seungju Choi
Department of Emergency Medicine, Daejin Medical Center, Bundang Jesaeng General Hospital, Seongnam, Korea
Correspondence  Youngsik Kim ,Tel: 031-779-0000, Fax: 031-779-0929, Email: emckys@dmc.or.kr,
Received: October 14, 2021; Revised: November 3, 2021   Accepted: November 9, 2021.  Published online: October 31, 2022.
ABSTRACT
Objective:
This study analyzed the urine cultures of emergency department patients diagnosed with acute uncomplicated cystitis and determined the antimicrobial resistance and appropriate treatment for our region.
Method:
Results of urine analysis and urine culture of acute uncomplicated cystitis patients diagnosed in our emergency department between January 2019 and December 2020 were examined and analyzed.
Results:
In our study, 256 out of 340 urine culture samples (75.3%) were positive for cystitis. The most common microorganism was reported to be Escherichia coli (93.0%). The resistance rates of E. coli to the following antimicrobial agents were as follows: amikacin (0.0%), ampicillin (63.5%), amoxicillin/clavulanate (15.6%), aztreonam (7.1%), ceftazidime (3.4%), cefotaxime (16.4%), cefoxitin (5.5%), cefazolin (19.9%), ciprofloxacin (29.4%), cefepime (1.7%), ertapenem (0.0%), gentamicin (18.1%), piperacillin/tazobactam (2.1%), trimethoprim/sulfamethoxazole (36.1%), and tigecycline (0.4%). The prevalence of extended-spectrum beta-lactamase producing E. coli strains was 17.8%.
Conclusion:
To determine the proper empirical antimicrobial treatment for acute uncomplicated cystitis, it is essential to examine the antimicrobial resistance. For our region, fosfomycin, nitrofurantoin, and 2nd and 3rd generation cephalosporin should be considered the first-line empirical treatment for acute uncomplicated cystitis.
Key words: Cystitis; Antibiotics; Drug resistance; Emergency department
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