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Clinical pharmacy and clinical trials (including case series)
Antibiotic prescription trends in UTIS at a hospital emergency department
  1. M.M. Galindo Rueda,
  2. M.J. Blazquez Alvarez,
  3. F. Mendoza Otero,
  4. A. De la Rubia Nieto,
  5. J.J. Pedreño Planes,
  6. V. Arocas Casañ
  1. 1Arrixaca Hospital Pharmacy, Murcia, Spain
  2. 2Arrixaca Hospital, Primary Care, Murcia, Spain

Abstract

Background Many patients visit the emergency department because of urinary tract infections (UTIs). Appropriate antibiotic prescriptions are necessary due to high resistance patterns and both the clinical and financial impact on the health system.

Purpose To describe characteristics of population diagnosed with UTIs attended at a tertiary hospital emergency department as well as the antibiotic prescription at discharge.

Materials and methods Retrospective study of adult patients attended at a hospital emergency department with a diagnosis at discharge of urinary tract infectious disease from January to June 2011. A random sample was selected. The authors analysed discharge reports to find: sex, age, main diagnosis, pregnancy, recent history of UTI and antibiotic prescription at discharge.

Results A total of 201 patients were included. (70.1% women, mean age 49.7 years). UTI was the most frequent diagnosis (188 patients, 93.5%) and 13 had an added urological disease. Antibiotics were prescribed to 91.54% of patients. Most often antibiotics prescribed were third generation cephalosporins cefixime and ceftriaxone (27.9%), followed by fosfomycin (26.4%) and fluoroquinolones (14.9%). Oral cefuroxime was prescribed in 10.9% patients and amoxicillin- clavulanic acid in 7%. The authors found out that 39 patients (19.4%) had a recent history of UTI. In those patients, the most frequently prescribed antibiotics were cephalosporins (46.1%) followed by fosfomycin (25.6%). Seven of the 141 women included in the study were pregnant. Four of them received cephalosporin, 2 fosfomycin and one of them amoxicillyn-clavulanic acid.

Conclusions Most patients attended at the emergency department due to UTI received an antibiotic prescription at discharge. The authors found a high rate of cephalosporin prescriptions. The authors should conduct a more extensive study including laboratory results and resistance rates in the region in order to assess the appropriate or inappropriate choice of the antibiotic therapy.

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