[Using antibiotics in urinary tract infection in a first level of attention health care unit in Bogotá, Colombia].
OBJECTIVE
Describing using antibiotics for urinary tract infection in a first level of attention health care unit.


METHODS
This was an observational and descriptive study of a cohort of register-based patients attending the Universidad Nacional de Colombia's Health Service Unit (UNISALUD) diagnosed as suffering urinary tract infection between July 2002 and June 2003.


RESULTS
6,3 % urinary tract infection incidence was found, especially affecting women (84,4 %). The signs and symptoms were the same as those usually found in this disease. 58% corresponded to lower tract infection, 36 % to non-specific infection, 4 % to infection during pregnancy and 2 % to upper tract infection. The following uropathogens were isolated: E. coli (88.9%), Proteus spp. (5,1%), Klebsiella spp. (3,7 %), Enterobacter spp. (1%), Citrobacter spp. (1 %) and Staphylococcus saprophyticus (0,3 %). There was great variability in the antibiotic schemes being prescribed. Nitrofurantoin, Trimethoprim-sulfamethoxizole and Fluoroquinolones were the most prescribed, per defined daily dose; these antibiotics presented low susceptibility for the uropathogens so isolated. There was a 4:1 ratio of empirical treatment respecting confirmed ones. 98 % of the cases corresponded to patients suffering from a single event or having just 1 to 2 recurrences. DISCUSSION The urinary tract infection studied here presented a similar epidemiological profile to that usually found in the general population. The isolated microorganism's low susceptibility to the prescribed antibiotics could reflect inappropriate use of antibiotics by the health service, inducing selective pressure on bacterial resistance.
Murillo-Rojas
Olga A
OA
Universidad Nacional de Colombia-UNISALUD. oamurillor@unal.edu.co
Leal-Castro
Aura L
AL
Eslava-Schmalbach
Javier H
JH
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D002954:Citrobacter / Q000302:isolation & purification; D015331:Cohort Studies; D024881:Drug Resistance, Bacterial; D004754:Enterobacter / Q000302:isolation & purification; D004926:Escherichia coli / Q000302:isolation & purification; D005260:Female; D024841:Fluoroquinolones / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007709:Klebsiella / Q000302:isolation & purification; D008297:Male; D008826:Microbial Sensitivity Tests; D009582:Nitrofurantoin / Q000494:pharmacology / Q000627:therapeutic use; D011247:Pregnancy; D011511:Proteus / Q000302:isolation & purification; D012737:Sex Factors; D013210:Staphylococcus / Q000302:isolation & purification; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology / Q000627:therapeutic use; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology
D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D009582:Nitrofurantoin