OPTIMIZING ANTIMICROBIAL PRESCRIBING FOR SUSPECTED UTIS IN GENERAL PRACTICE
Dr Vinay Kumar Haddannavar
Assistant professor, Department of General medicine, Nimra Institute of medical sciences,Jupudi,Vijayawada, India
Urinary tract infections (UTIs) rank as the second most common bacterial infections encountered in general practice, often necessitating antimicrobial therapy. However, the growing concern regarding antimicrobial resistance emphasizes the necessity for prudent pharmacotherapy in managing common infections. This study prospectively examined the management of UTIs in general practice over an 8-week period. Patients presenting with suspected UTIs provided urine samples, and an opt-out methodology was used for enrollment. Data encompassing demographic variables, prior antimicrobial usage, and urine sample results were collected. The appropriateness of various treatment approaches was evaluated by comparing prescribed treatments with laboratory reports of urine samples. A total of 44 practices participated, enrolling 1732 patients. Bacteriuria was confirmed in 21% of patients, pyuria without bacteriuria in 9%, and 70% showed no laboratory evidence of UTI. Despite this, antimicrobial agents were prescribed to 56% of patients, with variations observed among practices. The most frequently prescribed antimicrobials included co-amoxiclav (33%), trimethoprim (26%), and fluoroquinolones (17%). However, treatment as prescribed by general practitioners (GPs) was deemed appropriate for only 55% of patients. This study underscores the potential to enhance both the appropriateness and frequency of antimicrobial prescribing for suspected UTIs in general practice. Findings suggest a need for optimized prescribing practices, emphasizing the importance of judicious antimicrobial selection based on local resistance patterns and individual patient characteristics
13 , 2 , 2023
28 - 32