Escherichia coli resistance patterns, empiric and targeted antibiotic prescriptions in children: a single center experience

BACKGROUND AND AIM: Antibiotic resistance represents one of the major public health issues, due to the potential future ineffectiveness of available antibiotics. However, epidemiological studies on E. coli antibiotic resistance patterns in the pediatric population are limited. METHODS: We conducted a retrospective analysis on children younger than 18 years of age admitted to the Department of Pediatrics from April 2016 to April 2018 with E. coli isolation on biological materials. RESULTS: 205 subjects were included in the study (median 45 days, IQR 7-139 days). We found an overall low rate of resistance of E. coli isolates to amoxicillin/clavulanate (20%), cephalosporins (6.3%) and aminoglycosides (6.3%), while no isolates were resistant to carbapenems. Presence of invasive devices and intensive care admissions were associated with resistance to cephalosporines (P: < 0.001; OR 9.21, 95% CI 2.7 – 31.39) and aminoglycosides (P: < 0.004; OR 5.42, 95% CI 1.71 – 17.15), while no factors associated with resistance to the other antibiotics were found. CONCLUSIONS: Aminoglycosides and cephalosporins were frequently used as empirical therapy. On the other hand, once the antibiograms were available, targeted therapies aimed at sparing these classes of antibiotics were not always administered. Our study reports on local antimicrobial management in children and can guide the development of programs aimed at better use of antibiotics. (www.actabiomedica.it)