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Single centre observational study on antibiotic prescribing adherence to clinical practice guidelines for treatment
Thienan John Phamnguyen1, Grace Murphy2, Fahid Hashem3
1Department of Medicine, Gold Coast University Hospital, Southport, Queensland, Australia; School of Medicine, Griffith University, Gold Coast, Queensland, Australia; School of Medicine, Western Sydney University, Sydney, New South Wales, Australia.
Insights
Adherence to antibiotic prescribing guidelines for uncomplicated urinary tract infections was poor. Most non-adherence was due to incorrect dosage or duration, potentially linked to medication packaging.
Area of Science:
- Infectious Diseases
- Pharmacology
- Public Health
Background:
- Urinary tract infections (UTIs) are highly prevalent in both outpatient and inpatient settings.
- Antibiotic resistance is a critical global health challenge, necessitating adherence to treatment guidelines.
- Evaluating prescribing practices for uncomplicated UTIs is essential to combat resistance.
Purpose of the Study:
- To assess antibiotic prescribing adherence to national guidelines for uncomplicated UTIs.
- To identify deviations from established therapeutic recommendations in UTI management.
Main Methods:
- A retrospective study was conducted at Gold Coast University Hospital.
- 103 patients with uncomplicated UTIs were analyzed.
- Antibiotic prescriptions were evaluated against the Australian Therapeutic Guidelines.
Main Results:
- Only 45.6% of patients received guideline-adherent treatment.
- 46.6% of prescriptions did not adhere to guidelines, most commonly due to incorrect dose or duration.
- Justified non-adherence was noted in 7.8% of cases, with limited fluoroquinolone use observed.
Conclusions:
- Significant non-adherence to UTI treatment guidelines was identified.
- Incorrect antibiotic dosage and duration were primary reasons for non-adherence.
- Medication packaging may influence treatment duration adherence.
Background:
Urinary tract infections are one of the most common infections encountered in ambulatory care and the inpatient setting. Antibiotic resistance is a growing concern in healthcare worldwide and has been described by the World Health Organisation as one of the key global health issues facing our generation. The objective of this study was to evaluate antibiotic prescribing adherence to national therapeutic guidelines for patients with uncomplicated urinary tract infection.
Methods:
A single centre, retrospective study of patients with uncomplicated urinary tract infections presenting to the Gold Coast University Hospital in May 2015. Infections were categorised according to male cystitis, female cystitis, mild pyelonephritis and severe pyelonephritis, with antibiotic prescribing assessed against the Australian Therapeutic Guidelines.
Results:
103 patients met the inclusion criteria, 47 (45.6%) received treatment that adhered to the Australian Therapeutic Guidelines. Eight (7.8%) did not adhere but the decision of non-adherence was justified. 48 (46.6%) received treatment that did not adhere to the Australian Therapeutic Guidelines. The most common reason for non-adherence were incorrect dose followed by incorrect duration. There was a lack of fluoroquinolone use in this study.
Conclusions:
These results highlight the poor adherence to guidelines in uncomplicated urinary tract infection. Non-adherent duration of treatment is likely contributed by inappropriate number of tablets being dispensed in boxes.
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