Highlights
- •45.6% of patients with uncomplicated urinary tract infections received nonadherent treatment.
- •Incorrect dose, followed by incorrect duration of therapy were the most common reasons for non-adherence.
- •When duration of therapy was non-adherent, a common factor was an inappropriate quantity of tablets dispensed.
- •Fluoroquinolone use was significantly lower compared to similar non-Australian studies.
- •Antibiotic stewardship at the hospital level is important for improving antibiotic prescribing adherence.
Abstract
Background
Urinary tract infections are one of the most common infections encountered in ambulatory
care and the inpatient setting. Antibiotic resistance is a growing concern in healthcare
worldwide and has been described by the World Health Organisation as one of the key
global health issues facing our generation. The objective of this study was to evaluate
antibiotic prescribing adherence to national therapeutic guidelines for patients with
uncomplicated urinary tract infection.
Methods
A single centre, retrospective study of patients with uncomplicated urinary tract
infections presenting to the Gold Coast University Hospital in May 2015. Infections
were categorised according to male cystitis, female cystitis, mild pyelonephritis
and severe pyelonephritis, with antibiotic prescribing assessed against the Australian
Therapeutic Guidelines.
Results
103 patients met the inclusion criteria, 47 (45.6%) received treatment that adhered
to the Australian Therapeutic Guidelines. Eight (7.8%) did not adhere but the decision
of non-adherence was justified. 48 (46.6%) received treatment that did not adhere
to the Australian Therapeutic Guidelines. The most common reason for non-adherence
were incorrect dose followed by incorrect duration. There was a lack of fluoroquinolone
use in this study.
Conclusions
These results highlight the poor adherence to guidelines in uncomplicated urinary
tract infection. Non-adherent duration of treatment is likely contributed by inappropriate
number of tablets being dispensed in boxes.
Keywords
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Article info
Publication history
Published online: December 28, 2018
Accepted:
October 30,
2018
Received in revised form:
October 28,
2018
Received:
July 23,
2018
Identification
Copyright
Crown Copyright © 2018 Published by Elsevier B.V. on behalf of Australasian College for Infection Prevention and Control. All rights reserved.
