I order urine culture and sensitivity (C&S) when starting patients on antibiotic therapy for UTI. A number of C&S reports on otherwise healthy patients have shown Escherichia coli that is resistant to fluoroquinolones but sensitive to older antibiotics, such as amoxicillin. This strikes me as anomalous.—FRED BADER, MSHS, PA-C, Gaithersburg, Md.

The pattern you are describing is not typical. In California, 55% of outpatient and inpatient isolates of E. coli are sensitive to ampicillin/amoxicillin and 90% to ciprofloxacin. Sensitivities vary geographically. The hospital in your area can give you antibiotic sensitivity statistics for E. coli and other potential pathogens.—JoAnn Deasy, PA-C, MPH (143-1)

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