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• W2014282362 abstract "Ureteral stones commonly bring patients to the emergency department and can sometimes be complicated by urinary tract infection (UTI). The 2007 American Urology Association guidelines for the treatment of these patients states that “patients with bacteriuria should be treated with appropriate antibiotics.” However, no specific recommendation is made with regard to which antibiotic is most appropriate. The goal of this study is to determine antibiotic prescribing practices and bacterial resistance rates in patients with ureteral calculi and UTI. This study is a retrospective chart review performed from January 2008 - December 2009. The study was performed in an academic tertiary care center which sees approximately 55,000 patients per year. A structured data extraction form was used. The emergency department information system (Wellsoft Corp.) was queried for all patients who had a non-contrast computed tomogram (CT) of the abdomen and pelvis in the emergency department. The emergency department and inpatient discharge note (if present) for all potential subjects were reviewed. Inclusion criteria were age > 18 years-old, presence of a ureteral calculus on CT (collecting system through ureteral-vesico junction), and documented UTI on urinalysis or in the chart. Subjects were excluded if they presented to the emergency department already on antibiotics or had an indwelling catheter/nephrostomy tube. 742 patients were found by searching the database for patients who had a non-contrast abdominal CT performed. 38 (5%) of those patients met our inclusion/exclusion criteria. 26 (68%) of those included in the study had urine cultures performed in the emergency department. Of these 8 (31%) were positive (4 E coli, 2 Klebsiella, 1 Staphylococcus, and 1 Group B strep). There was no resistance to cefazolin, ampicillin, trimethoprim/sulfamethoxazole, gentamicin, or ciprofloxacin in any of the patients. However, both Klebsiella isolates were resistant to nitrofurantoin. Subjects were most often prescribed ciprofloxacin on discharge (47%) followed by trimethoprim/sulfamethoxazole (24%). Resistance to cefazolin, trimethoprim/sulfamethoxazole, ciprofloxacin, and gentamicin was non-existent in this small retrospective study. In contrast, there may be a high resistance rate to nitrofurantoin in this patient population. Ciprofloxacin, a relatively broad-spectrum antibiotic, may not be necessary for the treatment of infected ureteral calculi." @default.
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• W2014282362 date "2010-09-01" @default.
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• W2014282362 title "366: Bacterial Resistance Patterns In Patients With Ureteral Calculi and Urinary Tract Infections" @default.
• W2014282362 doi "https://doi.org/10.1016/j.annemergmed.2010.06.423" @default.
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