Change of Antibiotic Sensitivities to Causative Organisms of Urinary Tract Infection in Out Patients 2 years Before and After the Separation of Prescription and Dispensing Medicines

Background: The overuse and misuse of antimicrobial agents and their resultant emergence of resistant microorganisms have made choices regarding antimicrobial therapy more difficult. Therefore, a new system that separated prescribing and dispensing medicine began on July 1, 1997 to prevent overuse and misuse of medicine. We studied to evaluate changes of antibiotic sensitivities to causative microorganisms of urinary tract infection 2 years before and after the new medical system. Methods: During each 2 years before and after the new medical system, we analyzed antibiotic sensitivities of causative microorganisms for urinary tract infection among the 447 out-patients who visited a hospital in GangNeung. The diagnosis of urinary tract infection was based on greater than 10 5 CFU (Colony For Unit) per ml. urine. Results: The most common pathogenic microorganisms as E. coli (76.5%), followed by Klebsiella pneumoniae (5.1%), and Proteus mirabilis (3.6%) in urine culture. A first generation cephalosporin, cephalothin, against E. coli, had more significant sensitivity after the introduction of the new medical system (52.6%) than before (33.9%), especially in the 80th decade (P= 0.023) and in females (P< 0.001). Also, trimethoprim/sulfamethoxazole against E. coli showed signifcant improving sensitivity (P= 0.025). Conclusion: There was little change of antibiotic sensitivity of urinary tract infection in out-patients before and after the new medical system in cephalothin and trimethoprim/sulfamethoxazole against E. coli. The change of antibiotic sensitivities will require further observation for a longer term after the introduction of the new medical system.