Antibiotic Resistance in Complicated Urinary Tract Infections

Purpose: Complicated urinary tract infections are those that are assumed to be more difficult to treat due to factors related to the host or specific anatomical or functional abnormalities related to the urinary tract. Because of the widespread antibiotic resistance in these cases, we tried to create an algorithm for the empirical treatment of such infections. Material/Methods: The object of the study were 69 patients treated at the Urology Clinic of the "St. Anna-Varna" Hospital for a period of 1 year. Results: 18 of the patients had no previous urological problems. In them, the most common causative agent was Escherichia coli (44.4%) - with good sensitivity to carbapenems, gentamicin, sulperazone. 51 patients had previous urological problems, and here, the share of enterococci (27.3%) increased. These bacteria had good sensitivity to aminopenicillins and vancomycin. Conclusions: As a practical tip, we recommend Gram-staining of the urine 24th hour after taking the urine culture and changing the antibiotic if necessary, depending on whether the bacteria found are gram-negative or gram-positive.