Adherence to International Guidelines for the Treatment of Uncomplicated Urinary Tract Infections in Lebanon

Abstract

Objective The purpose of this study is to evaluate antibiotic-prescribing practices and adherence to IDSA guidelines for the treatment of uncomplicated urinary tract infections in Lebanon. Methods This observational prospective study was conducted in 15 community pharmacies in Lebanon over 1 year in adult females. A regimen of nitrofurantoin 100 mg bid for 5 days or fosfomycin 3 grams single dose were considered appropriate. For the bivariate analysis, the chi-square test was used. Results A total of 376 patients were included in this study. The prescribed antibiotic was appropriate in 35 percent of the patients. Age (more than 50 years) did not significantly affect the appropriateness of the prescribed antibiotic (p=0.508). The frequency of attacks per year (more than 3) negatively affected the choice of antibiotic (p=0.025). The dose and duration of the prescribed antibiotic was appropriate in 73 and 58 percent of the patients, respectively, with a significant inappropriate dose and duration with fluoroquinolones as compared to nitrofurantoin and fosfomycin (p < 0.001 for the dose and p=0.014 for the duration of therapy). Conclusions In an era of increasing bacterial resistance, interventions that improve physicians' prescribing practices for uncomplicated urinary tract infections are needed.

Prescribing pattern of antibiotics and guideline adherence in acute community-acquired uncomplicated urinary tract infections in Pakistani women

“…The higher rate of overall compliance was reported by Kim M, et al (34%) (13). The low adherence rate in this study was aligned with previously published studies (1,2,12,13). The importance of adherence to clinical practice guidelines cannot be denied and crucial for the reduction of unnecessary antibiotic practices (16,18).…”

“…Acute urinary tract infection (UTI) is among the most predominant community-acquired infection (1). Antibiotics are commonly prescribed for uncomplicated cystitis and pyelonephritis in healthy non-pregnant women (2,3).…”

Comparing febrile children presenting on and off antibiotics to the emergency department: a retrospective cohort study

“…In addition, it is important to note that 10% had a parenteral form prescribed. Lack of adherence to antibiotic use guidelines has already been documented in Lebanon [28,29] The above information on antibiotic use and misuse begs for national campaigns for antibiotic stewardship including guidelines and education A 2016 study of Lebanese hospitals showed that only 7% knew what the term antimicrobial stewardship meant, although around 65% reported having some type of antibiotic control program in the hospital and only 50% had an outcome measure in place [30]. However, in recent years, The Lebanese Society of Infectious Diseases has published several articles guiding the treatment of specific diseases such as UTIs and complicated intraabdominal infections [31,32].…”

Changes in the Management of Urinary Tract Infections in Women: Impact of the New Recommendations on Antibiotic Prescribing Behavior in France, Between 2014 and 2019

“…Some of these antibiotics are only used for treating acute cystitis (fosfomycin, nitrofurantoin, and lome oxacin), while others are prescribed for UTI management in general (pivmecillinam and nor oxacin) and also for other infection types (cipro oxacin, o oxacin and nor oxacin). Table 1 French guidelines for the treatment of acute uncomplicated cystitis Before December 2015 24 From December 2015 9,25 First line…”