Physicians' adherence to guidelines for empirical treatment of urinary tract infection in Taiwan.
OBJECTIVE
Guidelines for prescribing antibiotics for uncomplicated urinary tract infection (UTI) were established in Taiwan in 2000. This study investigated the extent of physicians' adherence to the guidelines for treating ambulatory women with UTI.


METHODS
National Health Insurance claims data were used to evaluate antibiotic prescription behavior for UTI among physicians serving in hospitals across the range of accreditation levels in Taiwan, including medical centers, regional hospitals, district teaching/non-teaching hospitals and community clinics. A random sample of 5047 female ambulatory care visits during 2001 and 2003 was analyzed.


RESULTS
Sulfonamides (trimethoprim and trimethoprim-sulfamethoxazole), first-generation cephalosporins and quinolones were the most commonly prescribed drugs. The overall guideline adherence rate for physicians was 72.1%. The differences in guideline adherence rates for physicians in medical centers (86.6%), regional hospitals (81.3%), district teaching/non-teaching hospitals (76.9%) and community clinics (69.5%) were statistically significant (chi-squared test; p<0.0001).


CONCLUSIONS
Physicians in community clinics were less likely to adhere to guidelines in the treatment of ambulatory cases of UTI than physicians in any of the different levels of accredited hospitals in Taiwan.
Jan
I-Shiow
IS
Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
Cheng
Shou-Hsia
SH
Hsu
Hui-Chun
HC
Hsueh
Po-Ren
PR
D000892:Anti-Infective Agents, Urinary / Q000627:therapeutic use; D003151:Community Health Centers / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D010820:Physicians; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D015363:Quinolones / Q000627:therapeutic use; D013449:Sulfonamides / Q000627:therapeutic use; D013624:Taiwan; D014552:Urinary Tract Infections / Q000188:drug therapy*
D000892:Anti-Infective Agents, Urinary; D015363:Quinolones; D013449:Sulfonamides