Purpose Although urinary tract infection (UTI) in pregnancy is a common medical problem, very little is known about the susceptibility patterns of bacteria causing UTI and the prescription practices for UTI in pregnancy in low-income countries. Studies were, therefore, carried out in southern India to document the susceptibility patterns and to compare these with prescription practices.Methods Data on susceptibility patterns of bacteria isolated in significant counts from urine of pregnant women suspected to have urinary infection were collected. Prescribing patterns for these infections were ascertained using a questionnaire.Results About 90% of E. coli causing UTI is still susceptible to nitrofurantoin, a relatively inexpensive and safe drug. However, less than 25% of doctors used it for treatment of cystitis. Cephalosporins were most commonly used in hospital practice for the treatment of UTI. Amoxycillin was being used widely to treat UTI in pregnancy in spite of high prevalence of resistance. There were wide variations in the duration of therapy and use of prophylaxis.Conclusions Our findings indicate an urgent need for proper guidelines, dissemination of information to practitioners and supervision of antimicrobial usage in low income countries like India. Irrational and unnecessary drug use can be expensive and harmful. Copyright (C) 2004 John Wiley Sons, Ltd.
Two hundred and ten strains of enterococci showing resistance to gentamicin (10 mu g/disc) were tested for high level resistance by detecting the minimum inhibitory concentration and by using high content disc diffusion test. Only 67 per cent of these had high level resistance to gentamicin. High level kanamycin resistance in the group was 84 per cent, while high level streptomycin resistance was 61 per cent. Only 85 of the 140 strains with high level gentamicin resistance had similar streptomycin resistance. Results using locally made high content discs, correlated 100 per cent with MIC results. High level resistance to enterococci should be reported on a routine basis, especially when isolated from patients with serious Infections.