An observational study of empirical antibiotics for adult women with uncomplicated UTI in general practice.
OBJECTIVE
Women presenting in primary care with symptoms suggestive of uncomplicated urinary tract infection (UTI) are commonly managed without urine culture. We therefore do not know how successful general practitioners (GPs) are at targeting antibiotic treatment to women who would have had a microbiologically confirmed UTI, or at avoiding antibiotics in those who would have had a negative culture, had all patients with a suspected UTI been sampled. We therefore explored the association between antibiotic prescribing and urine culture results when culture was performed in all symptomatic patients.


METHODS
GPs in nine general practices in South Wales were asked to submit urine specimens from all women consulting with clinically suspected, uncomplicated UTI. Patients were followed up 2 weeks later by questionnaire.


CONCLUSIONS
One hundred and thirteen adult women with a median age of 54 years were included and 61% received empirical antibiotics. There was very low agreement between the decision to prescribe empirically and subsequent culture result (Kappa = 0.04), with 60% of those prescribed empirical antibiotics subsequently found to have a negative culture, and 25% of those found to have a positive culture not prescribed empirical antibiotics. Current strategies to target empirical antibiotic prescribing in clinically suspected, uncomplicated UTI require review.
O'Brien
Kathryn
K
Department of Primary Care and Public Health, Cardiff University, 3rd Floor Neuadd Meirionnydd, Heath Park, Cardiff, UK. obrienka@cf.ac.uk
Hillier
Sharon
S
Simpson
Sharon
S
Hood
Kerenza
K
Butler
Christopher
C
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D024881:Drug Resistance, Bacterial; D004363:Drug Utilization; D005194:Family Practice; D005260:Female; D006801:Humans; D008875:Middle Aged; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D014852:Wales / Q000453:epidemiology
D000900:Anti-Bacterial Agents