BACTERIA ISOLATED IN 1994-1995 FROM WOMEN WITH UPPER GENITAL-TRACT INFECTIONS AND MEN WITH URETHRITIS - DISTRIBUTION AND ANTIMICROBIAL SUSCEPTIBILITY

Objective: Classify antibiotics according to their individual activity so as to identify those suitable for empiric therapy. Methods: We stu died bacterial strains isolated from patients with urethritis (n=189) and upper genital tract infections (n=163) between June 1994 and Febru ary 1995 in 3 hospital and 4 community laboratories. Upper genital tra ct infections were divided into two groups: proven infection on laparo scopy specimen (n=79) and suspected infection with isolation of pathog en in cervical samples (n=84). Pathogens isolated were: Chlamydia trac homatis in 36/12/15 cases respectively, Mycoplasma hominis in 12/20/13 , Ureaplasma urealyticum in 55/30/15, Neisseria gonorrhoeae in 40/2/0, Haemophilus spp in 20/2/1, group B streptococci in 7/1/8, E. coli in 8/1/17 and miscellaneous in 11/8/15. The minimal inhibitory concentrat ions for all strains were determined in 4 laboratories for ofloxacin, erythromycin and doxycyclin against C. trachomatis, M. hominis and U. urealyticum, and for ofloxacin, erythromycin, doxycyclin, amoxicillin + clavulanate, cefotaxime and gentamicin against the other strains, Th e activity score (% susceptibility to each antibiotic weighted by the frequencies of each isolate in urethritis and upper genital tract infe ction based on recent French epidemiologic data) was calculated for ea ch antibiotic. Conclusion: The antibiotics with the best empiric activ ity scores in urethritis were, in decreasing order: doxycyclin (90.4%) , ofloxacin (88.1%), and erythromycin (50.2%). The most active combina tions in upper genital tract infections were ofloxacin + amoxicillin ( 100%), doxycyclin + cefotaxime + metronidazole (95.9%) and doxycyclin + amoxicillin (95.3%).