Prescribing pattern of antibiotics and guideline adherence in acute community-acquired uncomplicated urinary tract infections in Pakistani women

Year 2019, Volume: 2 Issue: 4, 116 - 120, 22.09.2019

Zakir Khan , Junaid Khan Asghar Khan Faiz Ullah Khan Sohail Kamran Muhammad Nasir Jamal Khayal Muhammad

https://doi.org/10.32322/jhsm.601073

Abstract

Aim: Acute urinary tract infection is one of the most predominant
community-acquired infections. These infections are often treated with
antibiotics, but its inappropriate usage leads to Clostridium difficile
infections, resistance development and higher cost. To evaluate the prescribing
pattern of antibiotic and adherence to Infectious Diseases Society of America
(IDSA) guidelines in uncomplicated
urinary tract infections (cystitis and pyelonephritis) among females.

Material and Method: A retrospective, chart-review study was conducted
in a teaching hospital in Pakistan. Consecutively two hundred (n=200; cystitis:
n=100, pyelonephritis: n=100) medical charts of female patients kept for the
last 1 year (May 2018 to April 2019) were enrolled through random systematic
sampling technique for comparison purpose. Important information was extracted
from medical charts and compared with IDSA recommendations. Finally, collected
data were entered into SPSS, version 22.0 for statistical analysis, such as;
frequency, percentage and chi-square test. A p-value < 0.05 was considered
statistically significant.

Results: The most frequently prescribed antibiotic was ciprofloxacin
(58, 29%), followed by nitrofurantoin (39, 19.5%) and ceftriaxone (32, 16%).
About, 86 (43%) patients received an appropriate antibiotic. The dose was given
according to the guidelines in 84.5% of patients, whereas the duration of prescribed antibiotic was
appropriate in 61% of the patients, with a significant inappropriate dose and
duration in pyelonephritis patients. A total of 58 patients were completely
correct in all steps (drug, dose and duration). The appropriate prescribing of
antibiotic with respect to selection/choice, dose and duration were more in cystitis as
compared to pyelonephritis.

Conclusions: A low
adherence rate with guidelines was observed. Identifying barriers to guideline
adherence and urgent steps for the improved prescribing practices in uncomplicated urinary
tract infections are required.

Keywords

infection, women, antibiotic, Pakistan, guidelines

Supporting Institution

Not Applicable

Project Number

Not Applicable

Thanks

Thanks to the staff of selected hospital for their cooperation during data collection

References

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