A Survey of Outpatient Antibiotic Prescribing for Cystitis

Velasco, Edward; Noll, Ines; Espelage, Werner; Ziegelmann, Antina; Krause, Gérard; Eckmanns, Tim

doi:10.3238/arztebl.2012.0878

Cited by 12 publications

(9 citation statements)

References 19 publications

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“…The main limitation of our study is the low response rate in all groups compared to other physician surveys examining response rates using Internetbased and postal survey methods (McMahon et al 2003;Seguin et al 2004;VandenKerkhof et al 2004;Akl et al 2005;Leece et al 2006;Beebe et al 2007;Grava-Gubins and Scott 2008;Matteson et al 2011), where response rates of 24-80 percent were achieved for the postal groups and 29-63 percent for the Internet-based experimental groups. In one of our earlier physician surveys in Germany, we obtained a higher response rate of 36.4 percent (Merzenich et al 2012), similar to another physician survey on the national level with a response rate of 33 percent (Velasco et al 2012). However, low response rates similar to the current survey are an issue also for other physician surveys in Germany, for example, with a response rate of 16 percent (Gutsfeld et al 2014).…”

Section: Combining Internet-based and Postal Methodssupporting

confidence: 77%

See 1 more Smart Citation

Combining Internet‐Based and Postal Survey Methods in a Survey among Gynecologists: Results of a Randomized Trial

Ernst

Brand

Lhachimi

et al. 2017

Health Services Research

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In this study, primary care gynecologists were more likely to participate by traditional postal-only than by mixed-mode survey methods that first offered an Internet option. However, the lower response rate for the mixed-mode method may be partly due to the older age structure of the responding gynecologists. Variable costs per returned questionnaire were substantially lower in mixed-mode groups and indicate the potential for cost savings if the sample population is sufficiently large.

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Section: Combining Internet-based and Postal Methodssupporting

confidence: 77%

“…), similar to another physician survey on the national level with a response rate of 33 percent (Velasco et al. ). However, low response rates similar to the current survey are an issue also for other physician surveys in Germany, for example, with a response rate of 16 percent (Gutsfeld et al.…”

Section: Discussionmentioning

confidence: 65%

Combining Internet‐Based and Postal Survey Methods in a Survey among Gynecologists: Results of a Randomized Trial

Ernst

Brand

Lhachimi

et al. 2017

Health Services Research

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“…Furthermore, Velasco and colleagues conducted a nationwide survey of private practice physicians in Germany in order to determine factors affecting the use of TMP‐SMX or FQs as first‐line treatment of uncomplicated UTI . Independent factors associated with a preference for FQ prescribing included geographic location, switching from empiric to targeted treatment and patients who would have trouble returning for follow‐up, while gynaecologists were more likely to prescribe TMP‐SMX.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the trends and appropriateness of fluoroquinolone use in the outpatient treatment of acute uncomplicated cystitis at five family practice clinics

et al. 2019

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What is known and Objective: Despite recommendations to avoid fluoroquinolones (FQs) as a first-line treatment for uncomplicated cystitis, recent data suggest that FQs remain widely prescribed. Therefore, the objectives of this study were to evaluate the appropriateness of empiric FQ use compared to nitrofurantoin for uncomplicated cystitis and to determine whether there are any trends or predictors of empiric FQ versus nitrofurantoin use for uncomplicated cystitis.Methods: This retrospective study included women ages 19-64 years who were seen at five family medicine clinics and were prescribed targeted antibiotics (nitrofurantoin, ciprofloxacin or levofloxacin) for uncomplicated cystitis. Charts were reviewed to collect data, including symptoms, comorbidities, allergies, creatinine clearance, recent antibiotic use and urine culture data. Appropriateness of empiric selection was determined based on national guidelines and local susceptibility data. Results and discussion:A total of 677 patient encounters were screened for inclusion.Of those, 567 met the inclusion criteria: 395 nitrofurantoin and 172 FQs. Treatment was considered appropriate in 86.8% and 10.5% of cases that were prescribed nitrofurantoin and FQs, respectively (P < .01). There were four independent predictors of FQ use identified by multivariate logistical regression: clinic at which the patient was treated, age, nitrofurantoin use within 90 days prior to encounter and previous urine culture within one year with an organism non-susceptible to nitrofurantoin. What is new and conclusion:Despite recommendations against FQs for uncomplicated cystitis, they continue to be widely prescribed, and their use for this indication is often inappropriate. This highlights the need for additional interventions and education to improve use and preserve the utility of FQs. K E Y W O R D S cystitis, fluoroquinolones, outpatient antimicrobial stewardship, outpatient treatment, urinary tract infections 514 | ROBINSON et al. 1 | WHAT IS K NOWN AND OBJEC TIVE Acute uncomplicated cystitis remains one of the most common bacterial infections affecting healthy women, resulting in approximately 8 million office visits annually. 1,2 The 2010 Infectious Diseases Society of America (IDSA) guidelines for the treatment of uncomplicated cystitis consider the changes in resistance patterns, adverse effects and emergence of multidrug-resistant organisms. 1 They recommend the use of nitrofurantoin, fosfomycin and trimethoprim-sulfamethoxazole (TMP-SMX) where local resistance rates are <20% as first-line antibiotic regimens. 1 Although fluoroquinolones (FQs) (ciprofloxacin, levofloxacin) are highly effective for uncomplicated cystitis, they are considered alternatives due to their high propensity for collateral damage. Widespread FQ use has led to increased rates of methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa and Clostridium difficile. 1,3-5 This increased resistance is concerning not only in uncomplicated cystitis, but also in the treatment of more serious inf...

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“…Despite the resistance problem, perhaps because of the ease of oral use, TMP-SXT and quinolones still appear to be at the top on empirical prescriptions in several countries [12]. In our country, TMP-SXT resistance varies from 20% to 60% for E. coli strains isolated from community-acquired urinary tract infections (Table 4) [8,9,[13][14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Resistance patterns of gram negative bacteria in urinary tract infections and efficacy of empirical treatment in noncomplicated cases: Retrospective cohort study of 2180 women

Varışlı¹,

Hazırolan²,

Çelikbaş³

et al. 2018

Journal of Surgery and Medicine

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Aim: Community and hospital acquired urinary tract infections (UTI) are the most common bacterial infections in all age groups. In this study, the women diagnosed UTI, which complicated and uncomplicated, were referred to outpatient clinics between 2011 and 2015 were selected. The suitability of empirical antimicrobial therapy prescribed with resistance patterns of Gram negative bacteria isolated from these patients was investigated. Methods: UTI complaining and urine culture ≥10⁵ cfu / ml of bacteria that women aged 18-65 were comprised the study group. HIS (Hospital Information System Software) was scanned for these patients and uncomplicated and complicated UTI distinction was made according to the criteria set by Infectious Diseases Society of America (IDSA, 2016 Resistance patterns and empirical treatment in urinary tract infection P a g e / S a y f a | 100

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A Survey of Outpatient Antibiotic Prescribing for Cystitis

Abstract: SUMMARYBackground: In view of the currently increasing rates of antibiotic resistance, we studied the factors that affect the prescribing of specific antibiotics for uncomplicated cystitis in outpatient care.

Cited by 12 publications

References 19 publications

Combining Internet‐Based and Postal Survey Methods in a Survey among Gynecologists: Results of a Randomized Trial

Combining Internet‐Based and Postal Survey Methods in a Survey among Gynecologists: Results of a Randomized Trial

Evaluation of the trends and appropriateness of fluoroquinolone use in the outpatient treatment of acute uncomplicated cystitis at five family practice clinics

Resistance patterns of gram negative bacteria in urinary tract infections and efficacy of empirical treatment in noncomplicated cases: Retrospective cohort study of 2180 women

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