Influence of laboratory reports on prescribing of antimicrobials for urinary tract infection

The effect of laboratory reports, with restricted reporting of antibiotic information, on the prescribing of antimicrobials for urinary tract infection was assessed in a series of 250 patients. There was considerable prescribing of broad-spectrum antimicrobials, to which sensitivity was rarely reported, whether treatment was begun before or after the laboratory report was available, although they were used rather less in the latter situation. Of 147 patients with no evidence of bacteriuria, 26 (19%) received a full course of antimicrobial treatment. Of 49 asymptomatic catheterised patients with bacteriuria, 30 (61%) received antibiotics despite a recommendation to the contrary. The influence of laboratory reports is limited, and when the emergence and spread of resistant bacteria necessitates restraint with antimicrobials, restriction of antibiotic sensitivity reporting and recommendations by the laboratory may be insufficient.