OPTIMIZING HOSPITAL ANTIMICROBIAL FORMULARIES: A QUANTITATIVE AND QUALITATIVE ASSESSMENT OF KEY UROPATHOGENS

Introduction. In a multidisciplinary hospital operating in emergency medical care mode, the problem of urinary tract infections is of particular importance. According to the results of a recent Russian multicenter study IRKP ERGINI-2 (2022), Escherichia coli ranks second among the causative agents of nosocomial infections. Objective. The purpose of the study was to formulate recommendations for optimizing the treatment of urinary tract infections, considering the current levels of antibiotic resistance and the epidemiological context within the hospital. Results. This article examines the composition of uropathogens in a multidisciplinary hospital located in a major city in Siberia. It highlights the trend in the prevalence of Escherichia coli as the primary causative agent of urinary tract infections in the past decade. The constructed interval forecast predicts a continued increase in the proportion of this pathogen among the etiological factors associated with urinary tract infections, projecting that its share will exceed 25% by 2027. An evaluation of the qualitative characteristics of Escherichia coli strains revealed a persistently high level of resistance to commonly prescribed cephalosporins of the third and fourth generations, as well as fluoroquinolones of the second and fourth generations. The most effective antibiotics for treating urinary tract infections caused by E. coli include carbapenems (imipenem/chlorastatin, meropenem), fosfomycin, and polymyxin. Conclusion. The timely adjustment of treatment recommendations requires regular analysis of data on E. coli antibiotic resistance within the hospital environment. The findings should inform the development of hospital protocols for the empirical treatment of urinary infections, as the selection of an effective antimicrobial agent from the outset is crucial to determine prognosis, recovery speed, and treatment costs.