Objective: Monitoring antibiotic resistance, a global public health issue, is critical for guiding the rational use of empirical antibiotics. Understanding resistance profiles in each hospital is essential for effective management. A common approach is the annual evaluation of cumulative antibiogram data. In this study, we analyzed cumulative antibiogram data for urinary tract infections (UTIs) at our hospital, focusing on outpatient clinic and ward/intensive care unit patients. The goal was to assess current resistance trends and support appropriate empirical antibiotic selection.

Methods: Between December 2021 and November 2022, 3382 isolates from urine samples were analyzed - 2068 from outpatients and 1314 from ward/intensive care unit patients. Identification and antibiotic susceptibility testing were conducted using the BD Phoenix™ M50 system and disk diffusion, evaluated per EUCAST guidelines. Following the “Guide for the analysis and presentation of antibiotic sensitivity data,” only the first isolate per patient of the same bacterial species was included, and species with fewer than 30 isolates were excluded.

Results: In ward/intensive care unit isolates, antibiotic sensitivity rates are lower than in outpatient isolates. For Escherichia coli, the most common UTI agent, ertapenem (95.7%), imipenem (97.0%), and meropenem (96.6%) may be used empirically. In outpatients, nitrofurantoin (91.6%) for enterococci, meropenem (94.0%) for Proteus spp., and meropenem (96.0%), imipenem (98.0%), and ciprofloxacin (90.1%) for Enterobacter spp. are suitable. No antibiotic shows sufficient sensitivity for empirical use against Klebsiella pneumoniae, Pseudomonas aeruginosa, or Acinetobacter baumannii.

Conclusion: Due to varying resistance and risk of resistance development, culture-based treatment is recommended over empirical therapy, especially in ward and ICU UTI cases.