Antibiotic prescribing for acute and recurrent cystitis in primary care: a 4 year descriptive study.
OBJECTIVE
To explore the antibiotic prescribing pattern for cystitis and the patient-related variables associated with prescription during a 4 year period among Italian general practitioners (GPs).


METHODS
We obtained information from the 'Health Search Database' (HSD), an Italian general practice research database. From a total sample of 457 672 eligible patients aged >16 years registered up to December 2002, we included those whose diagnoses could be classified as acute (uncomplicated and complicated) and recurrent cystitis. Patients' features and prevalence of antibiotic users were assessed.


RESULTS
Of 35 129 cases diagnosed during the period 1999-2002, 96.0% of them were acute cystitis (39.2% recorded as uncomplicated). The prevalence of cases with acute complicated and uncomplicated cystitis slightly increased during the 4 year period, whereas it remained stable for recurrent cystitis. Most of the cystitis cases reported no diagnostic tests. More than 70% of patients were prescribed with at least one antibiotic, with a 4-fold increased risk of antibiotic use for acute cystitis throughout the study period. The prevalence of antibiotic users reached 86.2% for both acute uncomplicated and complicated cystitis in 2002, and 81.5% for recurrent cystitis. Fluoroquinolones represented the most common antibiotics being prescribed although they markedly decreased during these years. Fosfomycin trometamol use increased dramatically, becoming the first choice for any type of cystitis.


CONCLUSIONS
Data indicate an evident rise in antibiotic use mostly related to fosfomycin trometamol. They also indicate that such a prescriptive trend finds confirmation from the available evidence for acute uncomplicated cystitis, although the management of recurrent cystitis could be further improved.
Galatti
Laura
L
Department of Clinical and Experimental Medicine and Pharmacology, University of Messina, Torre Biologica-Policlinico Universitario, Via Consolare Valeria-Gazzi, 98125 Messina, Italy. lgalatti@unime.it
Sessa
Aurelio
A
Mazzaglia
Giampiero
G
Pecchioli
Serena
S
Rossi
Alessandro
A
Cricelli
Claudio
C
Schito
Gian Carlo
GC
Nicoletti
Giuseppe
G
Caputi
Achille P
AP
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000592:standards / Q000627:therapeutic use*; D003556:Cystitis / Q000188:drug therapy* / Q000473:pathology; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors
D000900:Anti-Bacterial Agents