Ost drug resistant (Boggan et al. 2012; David et al. 2006). Nonetheless, this trend was obscured by the institution-wide antibiogram which reported typical values, hence overestimating resistance in pediatric isolates and underestimating resistance in isolates from the elderly. A high prevalence of E. coli and S. aureus drug resistance within the elderly is welldocumented and probably reflects higher comorbidities, hospitalizations, and antimicrobial exposure among olderTable 2 Susceptibility of E. coli, S. aureus, and S. pneumoniae isolates by patient age and place, Mayo Clinic Rochester, MN18 y IP E. coli Ampicillin AMP-SLB Cefazolin Ceftriaxone Gentamicin Ciprofloxacin TMP-SMX Nitrofurantoin S. aureus Oxacillin or Cefazolin Clindamycin Levofloxacin TMP-SMX n = 39 28 30 77 87 87 82 59 100 n = 91 77 81 88 100 OP n = 267 51 41 96 98 97 96 77 99 n = 317 78 82 91 100 0.88 0.78 0.51 n/a 0.008 0.19 0.001 0.004 0.022 0.001 0.015 0.99 p-value IP n = 318 48 40 86 93 89 73 74 95 n = 533 66 62 64 99 18-64 y OP n = 1105 57 50 93 97 93 83 74 98 n = 957 73 73 78 99 0.003 0.001 0.001 0.96 0.005 0.004 0.001 0.01 0.026 0.001 0.Linoleic acid 91 0.15 p-value IP n = 499 58 52 90 96 91 73 81 97 n = 479 52 49 45 99 65 y OP n = 1116 55 50 92 98 90 71 74 97 n = 577 65 65 58 98 0.001 0.001 0.001 0.039 0.19 0.51 0.24 0.12 0.64 0.38 0.002 0.96 p-valueInpatient (IP), outpatient (OP), ampicillin-sulbactam (AMP-SLB), trimethoprim-sulfamethoxazole (TMP-SMX), oxacillin (ox), cefazolin (cef).Swami and Banerjee SpringerPlus 2013, two:63 http://www.springerplus/content/2/1/Page four ofpatients (David et al. 2006; Swami et al. 2012). In contrast, for S. pneumoniae, pediatric isolates were additional drug resistant than adult isolates. The higher drug resistance among pediatric S.pneumoniae isolates is likely due to the high utilization of penicillins in young children and the likelihood that the S. pneumoniae isolates utilized to make the antibiogram reflected difficult or refractory infections, considering that S. pneumoniae isn’t routinely cultured in uncomplicated otitis media or pneumonia. Clinician reliance on institution-wide antibiograms that don’t accurately reflect susceptibility prices in certain patient groups may possibly bring about inappropriate empiric antibiotic prescribing. Overestimating resistance in pediatric S. aureus or E. coli could cause prescribing of unnecessarily broad antibiotics in young children which, in turn, can bring about increasingly drug resistant pathogens and C. difficile infections. For instance, we’ve observed that local providers stay away from clindamycin for therapy of pediatric skin and soft tissue infections since the cumulative antibiogram reports higher prices of clindamycin resistance.Amrubicin An age-stratified analysis revealed that in our geographic region, clindamycin susceptibility amongst pediatric S.PMID:34856019 aureus isolates is above 80 and this drug remains an important therapeutic solution for treatment of skin and soft tissue infections, which includes MRSA, in youngsters but not in older adults. Similarly, providers in our community have followed national trends (Copp Hersh 2011) by increasingly prescribing third generation cephalosporins for empiric treatment of pediatric urinary tract infections. Prescribing of fewer broad spectrum agents could possibly be encouraged by creation and dissemination of a pediatric antibiogram demonstrating E. coli with higher susceptibility to narrow – spectrum cephalosporins. Boggan et al. recently reported.