Low Concordance With Guidelines for Treatment of Acute Cystitis in Primary Care

Grigoryan, Larissa; Zoorob, Roger; Wang, Haijun; Trautner, Barbara W.

doi:10.1093/ofid/ofv159

Cited by 63 publications

(83 citation statements)

References 37 publications

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“…[6] Adherence to guidelines in primary care has been shown to vary significantly depending on the condition being treated. [7][8][9][10][11][12][13] Studies have shown poor guideline adherence for respiratory problems, [7][8][9][10] urinary tract infections, [11,12] tonsillitis [13] and acute diarrhoea. [10] Other variables associated with poor adherence include seniority of the clinician, [14] prescriber workload, [15] patient age [8,14] and area-level socioeconomic status.…”

Section: Researchmentioning

confidence: 99%

“…One study showed that 82% of trimethoprim prescriptions, 73% of nitrofurantoin prescriptions and 71% of fluoroquinolone prescriptions for UTIs were prescribed for longer periods than guidelines recommended. [11] For patients with respiratory problems, only 34.1% of cases were adherent to guidelines. Of those that were not adherent, 48.3% of the errors were because the antibiotic was not required (Fig.…”

Section: Physiological System and Type Of Antibioticmentioning

confidence: 99%

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Antibiotic prescribing practice and adherence to guidelines in primary care in the Cape Town Metro District, South Africa

2018

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Section: Researchmentioning

confidence: 99%

Section: Physiological System and Type Of Antibioticmentioning

confidence: 99%

Antibiotic prescribing practice and adherence to guidelines in primary care in the Cape Town Metro District, South Africa

2018

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“…Ciprofloxacin and levofloxacin were prescribed for 3 days in 29.0% of patients only; a similar situation was observed for trimethoprim/ sulphamethoxazole which was prescribed for 3 days in only 16% of patients, and nitrofurantoin, administered for 3 days in 14% of cases only. 29 The most concerning aspects were the first-line use of fluoroquinolones and the long-term administration of all the antibiotics for the management of uncomplicated UTIs.…”

Section: Asymptomatic Bacteriuriamentioning

confidence: 99%

Clinical evaluation of guidelines and therapeutic approaches in multi drug-resistant urinary tract infections

Concia

Bragantini

Mazzaferri

2017

Journal of Chemotherapy

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“…In addition to improving patient outcomes, increased concordance with guidelines could support more rational antibiotic prescribing, thereby helping to mitigate antimicrobial resistance . Australian studies have evaluated the level of concordance between antibiotic therapy prescribed for hospital inpatients and recommendations in Therapeutic Guidelines .…”

Section: Introductionmentioning

confidence: 99%

Concordance with antibiotic guidelines in Australian primary care: A retrospective study of prior‐to‐hospital therapy

et al. 2019

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Summary BackgroundAppropriate antibiotic prescribing improves patient outcomes and mitigates antimicrobial resistance. As the majority of antibiotics are used in the community, rational prescribing in this setting is of paramount importance. ObjectivesWe aimed to (1) evaluate the concordance of community antibiotic prescribing with guidelines for three common infection types among patients who presented to hospital, and (2) identify relationships between guideline concordance and patient‐related factors. MethodsMedical records were evaluated from the Royal Hobart Hospital (Tasmania, Australia) for patients presenting with respiratory tract, urinary tract or skin and soft tissue infections within a 12‐month period. Prior‐to‐hospital antibiotic therapy was assessed for concordance with prescribing guidelines based on presenting diagnosis. Concordance was assessed against first‐line recommendations in the Australian Therapeutic Guidelines ‐ Antibiotic, based on drug choice, dose, frequency and patient factors. Descriptive statistics were performed to address Objective 1. Multivariate logistic regressions were conducted to address Objective 2 with the following independent variables: infection type, age, allergies, diabetes status, gender and residential setting. ResultsA total of 285 patient records were eligible for data analysis; 28.8% (n = 82) were fully guideline concordant. The most common reason for non‐concordance was inappropriate drug choice (n = 143, 50.2%). Patients with the following characteristics were less likely to receive concordant therapy: diabetes (OR = 0.3, 95% CI 0.1‐0.8, P = .02) and increasing age (OR = 0.99, 95% CI 0.98‐1.00, P = .04). ConclusionsAlmost three‐quarters of patients received community‐initiated antibiotic therapy that was not fully guideline concordant. Antimicrobial stewardship interventions are urgently needed to improve guideline concordance for community‐initiated antibiotic therapy.

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Low Concordance With Guidelines for Treatment of Acute Cystitis in Primary Care

Abstract: We found low concordance with the updated 2010 IDSA guidelines for both the choice of drug and duration of therapy for acute cystitis. Interventions to decrease overuse of fluoroquinolones are needed to preserve the antimicrobial efficacy of these important antimicrobials.

Cited by 63 publications

References 37 publications

Antibiotic prescribing practice and adherence to guidelines in primary care in the Cape Town Metro District, South Africa

Antibiotic prescribing practice and adherence to guidelines in primary care in the Cape Town Metro District, South Africa

Clinical evaluation of guidelines and therapeutic approaches in multi drug-resistant urinary tract infections

Concordance with antibiotic guidelines in Australian primary care: A retrospective study of prior‐to‐hospital therapy

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