Resistance exceeds 20% in many antibiotics used for paediatric E coli UTIs

A systematic review by UK researchers revealed that in OECD countries half of all E coli isolates are resistant to ampicillin.

In addition, in OECD countries, a third of isolates were resistant to co-trixmoxazole and a quarter to trimethoprim. Resistance was significantly greater in non-OECD countries
The researchers were endeavouring to identify the global prevalence of resistence to commonly prescribed antibiotics in children with communit-acquired E. coli UTIs. The research was published in the BMJ. The researchers noted that these findings confirm their previous review suggesting that previous antibiotic use in primary care increased the subsequent risk of E. coli resistance to that particular antibiotic.
 
In an accompanying editorial, Professor Grant Russell ofthe  School of Primary Health Care, Monash University, Melbourne the findings have important implications for the management of paediatric UTI management in primary care. He suggests there is a case for a change in guidelines for for "first choice" antibotics in this setting.
 
Variablilty in resistance suggests that clinicians need access to up-to-date resistance patterns within their own geographic area. According to Professor Russell, GPs will most likely need to take an "antibiotic history" before prescribing antibiotics. GPs will have to weigh up parents' claims that "antibiotic x always works for my child" against the idea that if that antibiotic was used in the last 6 months, there's a good chance that it's not going to work as well if used again.