Three-Year Trend in Antimicrobial Resistance among Children's Urine Cultures in an Italian Metropolitan Area.

Urinary tract infections (UTIs) are among the most common bacterial infections in children, and is the main pathogen responsible. Several guidelines, including the recently updated Italian guidelines, recommend amoxicillin-clavulanic acid (AMC) as a first-line antibiotic therapy in children with febrile UTIs. Given the current increasing rates of antibiotic resistance worldwide, this study aimed to investigate the three-year trend in the resistance rate of isolated from pediatric urine cultures (UCs) in a metropolitan area of northern Italy. We conducted a retrospective review of -positive, non-repetitive UCs collected in children aged from 1 month to 14 years, regardless of a diagnosis of UTI, catheter colonization, urine contamination, or asymptomatic bacteriuria. During the study period, the rate of resistance to AMC significantly increased from 17.6% to 40.2% ( < 0.001). Ciprofloxacin doubled its resistance rate from 9.1% to 16.3% ( = 0.007). The prevalence of multidrug-resistant rose from 3.9% to 9.2% ( = 0.015). The rate of resistance to other considered antibiotics remained stable, as did the prevalence of extended spectrum beta-lactamases and extensively resistant among isolates. These findings call into question the use of AMC as a first-line therapy for pediatric UTIs in our population, despite the indications of recent Italian guidelines.