Prescription of antibiotics for urinary tract infections in outpatient care in Bavaria: An analysis of routine data

Thomas Hanslmeier ¹, Sahera Alsaiad ¹, Susann Hueber ²

⁰Department of General Practice, University Hospital Würzburg, Würzburg, Bavaria, Germany.

Plos One +

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October 25, 2024

View abstract on PubMed

Summary

German antibiotic prescribing for urinary tract infections (UTIs) is becoming more guideline-adherent. Fosfomycin and pivmecillinam use increased, while fluoroquinolones decreased, especially in women.

Area Of Science

Infectious Diseases
Pharmacology
Public Health

Background

German guidelines recommend specific first-line antibiotics for urinary tract infections (UTIs) to combat resistance.
Despite recommendations, a notable proportion of second-line antibiotics were previously observed in German outpatient care.
Prescribing patterns for UTIs may vary by physician specialty, patient age, and sex.

Purpose Of The Study

To analyze trends in antibiotic prescribing for UTIs in German outpatient care from 2013 to 2019.
To investigate variations in UTI antibiotic prescriptions based on physician specialty, patient age, and sex.
To assess changes in antibiotic prescriptions when multiple treatments were administered.

Main Methods

Retrospective analysis of routine healthcare data from Bavaria, Germany (2013-2019).
Inclusion of urinary tract infection (UTI) patients aged 12 years and older.
Examination of 1.7 million UTI prescription cases.

Main Results

Prescription of fluoroquinolones significantly decreased over time, particularly in females.
Use of first-line antibiotics, fosfomycin and pivmecillinam, increased, especially among women.
Gynecologists demonstrated higher adherence to first-line antibiotic recommendations compared to general practitioners and urologists.

Conclusions

Antibiotic prescribing for UTIs in Germany shows a positive trend towards guideline adherence.
Increased use of fosfomycin and pivmecillinam, alongside a decrease in fluoroquinolone prescriptions, indicates improved UTI treatment strategies.
Further research may explore nuances in prescribing for different patient demographics and sequential treatments.