Jahnavi Sarma
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Written By: Jahnavi Sarma | Published : February 27, 2021 1:55 PM IST
According to researchers, inappropriate antibiotic prescriptions for uncomplicated urinary tract infections are prevalent and come with serious patient- and society-level consequences.
Urinary tract infection is common among women. And, uncomplicated urinary tract infection happens in patients with a normal, unobstructed genitourinary tract. These patients usually do not have a history of recent instrumentation and their symptoms are also confined to the lower urinary tract. This kind of UTIs are common among young, sexually active women. But unfortunately, almost half of all the women with uncomplicated urinary tract infections receive the wrong antibiotics and almost three-quarters of them receive prescriptions for longer than is necessary. This leads to inappropriately long treatment durations. This is what a new study of private insurance claims data by Washington University School of Medicine, St. Louis, says. Researchers of this study also say that this is more common in rural areas. Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America, published this study.
According to researchers, inappropriate antibiotic prescriptions for uncomplicated urinary tract infections are prevalent and come with serious patient- and society-level consequences. The findings of this study, according to them, underscore the need for antimicrobial stewardship interventions to improve outpatient antibiotic prescribing, particularly in rural settings. For the purpose of the study, researchers studied the insurance claims data for 670,400 women ages 18 to 44 who received an outpatient diagnosis of uncomplicated urinary tract infection between April 2011 and June 2015. They identified filled antibiotic prescriptions, assessed adherence to clinical guidelines, and compared rural and urban antibiotic usage patterns.
Researchers saw that rural patients were more likely to receive a prescription for an inappropriately long duration of therapy than urban patients, according to an analysis of geographic data from the claims database. While use of both inappropriate antibiotic choice and inappropriate duration of prescriptions declined slightly over the study period, inappropriate prescriptions continued to be common with 47 per cent of prescriptions written for antibiotics outside guideline recommendations and 76 pr cent for an inappropriate duration, nearly all of which were longer than recommended.
According to researchers of the above-mentioned study, accumulating evidence suggests that patients have better outcomes when doctors shift from prescribing from broad-acting to narrow-spectrum antibiotics and from longer to shorter durations. They also add that promoting optimal antimicrobial use benefits the patient and society by preventing avoidable adverse events, microbiome disruption, and antibiotic-resistant infections.
One reason for this may be the fact that rural healthcare providers may not be as aware of current antibiotic treatment guidelines as their counterparts in urban cities and metros. In addition, urban healthcare providers who treat rural patients may prescribe longer antibiotic durations because of distance-to-care barriers in case symptoms persist. The researchers of this study say that further research is needed to identify reasons for higher inappropriate prescribing in rural settings.
Researchers say that clinicians should periodically review clinical practice guidelines, even for common conditions, to determine the ideal antibiotic and treatment duration. Auditing outpatient antibiotic prescribing patterns and periodic feedback to healthcare provider helps remind clinicians of the best practices and improves antibiotic prescribing. However, additional research should be performed to understand and ultimately improve rural outpatient antibiotic prescribing practices for urinary tract infections and other common conditions.
(With inputs from Agencies)
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