Inappropriate Antibiotic Prescribing Rates High for Uncomplicated UTIs
Information about the antibiotic class and the duration of treatment were compared to the recommendations issued by the IDSA.
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SAN DIEGO — Results of a study presented at IDWeek 2017 found that inappropriate prescribing of outpatient antibiotics for the treatment of uncomplicated urinary tract infections (UTI) are higher than previously estimated and declined only modestly after the 2011 release of new Infectious Diseases Society of America (IDSA) guidelines.
Outpatient claims data of 654,432 non-pregnant, 18 to 44-year old women with an index uncomplicated UTI were obtained from the Truven Health Analytics MarketScan Commercial Claims database and analyzed. To assess appropriateness of treatment, information about the antibiotic class and the duration of treatment were compared to the recommendations issued by the IDSA. The study authors considered the “start” of the post-guideline period to be one month after the April 2011 date of IDSA guideline publication.
Following the release of the IDSA guidelines, inappropriate agent prescribing dropped slightly from 49.8% to 47.85% and inappropriate durations were prescribed 77.4% and 75.7% of the time before and after promulgation of the guidelines (P <.001). Although the changes were statistically significant, they were "unlikely clinically significant" improvements, the authors noted.
"Fluoroquines, a non-first line agent, remain the most commonly prescribed antibiotic for uncomplicated urinary tract infections," the researchers reported. "After the release of the IDSA guideline, over 75% of antibiotic prescriptions for uncomplicated UTIs were for the wrong treatment duration."
The IDSA guideline has not yielded "meaningful changes in type and duration of outpatient antibiotic prescribing practices for uncomplicated UTIs," they reported.
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Durkin MJ, Keller M, Kwon JH, Dubberke ER, Olsen MA. An estimate of inappropriate antibiotic prescribing rates for outpatient uncomplicated urinary tract infections. Presented at: IDWeek 2017; October 4-8, 2017; San Diego, CA. Abstract 431.