Nosocomial infection of the urinary tract: pattern of antibiotic use and drug resistance

Abstract

Nosocomial infection of the urinary tract is a long standing problem that pre-dates the antibiotic era. Hospitals have remained veritable reservoirs of bacteria with increased numbers and types resistant to antibiotic treatment. Most hospitals have epidemiologists and infection control manuals but unfortunately most hospital staff do not follow infection control protocols. Whenever a new class of antibiotics become available, enthusiastic physicians rush to use them discarding the older and slightly less potent ones which are subsequently regarded as obsolete. Some individuals claim that "good medicine is supposed to be practiced by those physicians who give their patients the most up to date drugs available". However, the resistance and sensitivity pattern of bacteria have changed and continue to do so, varying widely even among facilities within the same community. Furthermore, within several years of each antibiotic advancement, a parallel increase in the resistant strains of previously sensitive bacteria has been observed. The problem of resistant pathogens has become particularly important within the context of nosocomial infection of the urinary tract. Reduced hospital stay and avoidance of bacterial resistance by rational and selective use of antibiotics for preoperative prophylaxis and definitive therapy and strict enforcement of the hospital disease control protocols must be encouraged.