title: A survey of outpatient antibiotic prescribing for cystitis.
abstract: BACKGROUND
  In view of the currently increasing rates of antibiotic resistance, we studied the factors that affect the prescribing of specific antibiotics for uncomplicated cystitis in outpatient care.
  
  
  METHODS
  A nationwide cross-sectional survey of physicians in private practice in various specialties (internal medicine, general medicine, surgery, obstetrics/gynecology, child and adolescent medicine, otorhinolaryngology, dermatology, urology) was carried out in 2008. The sample was derived from the German state directories of medical specialists.
  
  
  RESULTS
  1810 (60%) of the physicians surveyed reported that they made decisions about antibiotic treatment every day, with uncomplicated urinary tract infection as the most common diagnosis (715 physicians). The antibiotics that they prescribed most commonly for it were cotrimoxazole (61%) and fluoroquinolones (21%). The following factors were significantly associated with a preference for fluoroquinolones: being a gynecologist (odds ratio [OR] 0.47, 95% confidence interval [CI] 0.27-0.80), location of practice in the former East Germany (OR 2.01, CI 1.16-3.46), a treatment strategy incorporating a switch from empirical to targeted treatment (OR 1.72, CI 1.02-2.90), and the stated intention of avoiding inconvenience to the patient (OR 2.14, CI 1.25-3.68).
  
  
  CONCLUSIONS
  Fluoroquinolones are no longer recommended as the drug of first choice for uncomplicated urinary tract infections because of the development of resistance, but are still commonly prescribed for it. ARS (Antibiotic Resistance Surveillance in Germany) publishes current regional and patient-group-specific resistance rates to promote good clinical practice and improve prescribing behavior.
authors.affiliation: Robert Koch Institute Berlin, Berlin, Germany. velascoe@rki.de
authors.forename: Edward
authors.initials: E
authors.lastname: Velasco
authors.forename: Ines
authors.initials: I
authors.lastname: Noll
authors.forename: Werner
authors.initials: W
authors.lastname: Espelage
authors.forename: Antina
authors.initials: A
authors.lastname: Ziegelmann
authors.forename: Gérard
authors.initials: G
authors.lastname: Krause
authors.forename: Tim
authors.initials: T
authors.lastname: Eckmanns
mesh_terms: D000553:Ambulatory Care / Q000706:statistics & numerical data*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003556:Cystitis / Q000188:drug therapy* / Q000453:epidemiology*; D005858:Germany / Q000453:epidemiology; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D055656:Prescriptions / Q000706:statistics & numerical data*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents