Urinary tract infections, antibiotic resistance and sales of antimicrobialdrugs - An observational study of uncomplicated urinary tract infections in Icelandic women

Objectives - To analyse the antimicrobial susceptibility pattern of bacteri a causing symptomatic but otherwise uncomplicated lower urinary tract infec tions (UTI) in primary health care and the sales of antimicrobial drugs. Setting - Primary health care in Akureyri District, Northern Iceland, with about 17400 inhabitants. Patients - A total of 516 episodes of symptomatic but otherwise uncomplicat ed lower UTI in women 10 to 69 years of age. Main outcome measures - Number of verified UTI, bacterial species, antimicr obial susceptibility pattern, and total sales of antimicrobial drugs. Results - Escherichia coli was by far the most common cause of UTI (83%), f ollowed by Staphylococcus sarvophyticus (7%). Infections caused by E. coli resistant to ampicillin accounted for 36% of cases, with the corresponding figures for sulfafurazol being 37%, cephalothin 45%, trimethoprim 13% and m ecillinam 14%. Only 1% of the strains were resistant to nitrofurantoin. The total use of antimicrobial drugs was 17.4 DDD/1000 inhabitants/day. Conclusions - The resistance of bacteria causing uncomplicated UTI to commo n antimicrobials is high and must be taken into account when selecting trea tment strategies. High consumption of antibiotics in the community indicate s possible association.