Single centre observational study on antibiotic prescribing adherence to clinical practice guidelines for treatment of uncomplicated urinary tract infection

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.