Prospective Evaluation of Antibiotic Sensitivities for Uncomplicated Cystitis at Banner – University Medical Center Tucson’s Emergency Department

Abstract

Objectives: To determine if the uncomplicated cystitis population at Banner - University Medical Center Tucson’s (BUMCT) emergency department (ED) is significantly different from the hospital-wide antibiogram. Methods: A prospective, analytical, observational study was performed in the ED at BUMCT. Electronic health records were used to include or exclude patients in the study. Cultures were then compiled and compared to the hospital-wide, 2014 BUMCT antibiogram using a one sample Chi-square goodness of fit test to determine if there was a significant difference between the two proportions. Results: 159 cultures and susceptibilities were analyzed with E. coli and K. pneumoniae being the most common organisms. For E. coli, it was observed that 46.92% were susceptible to ampicillin while 45% was reported by the hospital’s antibiogram (P=0.772), 93.08% compared to 88% for cefazolin (P=0.185), 94.62% compared to 93% for ceftriaxone (P=0.611), 83.08% compared to 78% for ciprofloxacin (P=0.332), 89.23% compared to 90% for nitrofurantoin (P=0.850), and 63.85% compared to 66% for TMP/SMX (P=0.735). For K. pneumoniae, it was observed that 100% of isolates were susceptible to cefazolin, ceftriaxone, and ciprofloxacin compared to 95%, 96%, and 95%, respectively (P=0.254; P=0.309; P=0.254); 40% compared to 28% for nitrofurantoin (P=0.243); and 88% compared to 91% for TMP/SMX (P=0.649). Conclusions: The observed and predicted susceptibilities were not different for any of the drugs and organisms. Our study indicates that the hospital-wide antibiogram used at BUMCT is adequate in treating patients with uncomplicated cystitis coming into their ED.