Why do rates of antimicrobial resistant UTI differ across the world?

It’s well known that rates of antibiotic resistance differ between countries and that previous exposure to antibiotics increases resistance. A recent study in the BMJ looked at rates of resistance in paediatric UTI’s across the globe.The study stratified countries based on their OECD status (either in or out) and used random effects  meta-analysis to determine the risks of a child contracting a resistant E. coli UTI.

The analysis showed that children previously exposed to antibiotics had a higher risk of having a resistant organism. Rates are higher is countries outside the OECD, possibly because of the unrestricted availability of antibiotics over the counter in pharmacies. Other factors present in less developed countries, such as poor sanitation and access to healthcare, may also be factors increasing resistant strains in the environment.

Increased urine sampling may also improving treatment success as the appropriate antibiotics are prescribed initially rather than after treatment failure.

This analysis showed that higher rates of resistance were seen up to six months post antibiotic treatment, suggesting that the effect of inappropriate antibiotics (prescribed or otherwise) can linger.

This is further evidence that indiscriminate use of antibiotics increases resistance and that clinical effects can persist for some time after the course of antibiotics are completed.




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