Treatment of Cystitis by Hungarian General Practitioners: A Prospective Observational Study

Abstract

Background: Lower urinary tract infections (LUTIs) are amongst the most common community acquired infections with frequent antibiotic prescribing. Objectives: To assess empiric antibiotic choice in different types of lower urinary tract infections. We also aimed to identify determinants of fluoroquinolone prescribing, as well as to determine the rate of short antibiotic courses. The frequencies of executing laboratory tests and recommending analgesics/anti-inflammatory drugs were also assessed. Methods: A prospective observational study was performed in 19 different Hungarian primary care practices. Participating general practitioners (GPs) filled out data sheets for each patient with a suspected urinary tract infection. Details of drug use were evaluated. Comparison of different LUTI groups were made by descriptive statistics and univariate analysis. Possible determinants of fluoroquinolone prescribing were assessed by logistic regression. Results: Data sheets of 372 patients were analyzed. The majority of patients (68.82%) had acute uncomplicated cystitis. While antibiotics were prescribed for almost every patient (uncomplicated cases: 92.58%, complicated cases: 94.83%), analgesics/antiinflammatory drugs were recommended at a rate of 7.81% in uncomplicated, and 13.79% in complicated cystitis cases. Ciprofloxacin was the most commonly prescribed antibacterial agent in both types of cystitis. Short-term antibiotic therapy was prescribed in one third of relevant cases. Logistic regression found a weak association between fluoroquinolone use and patient's age and presence of complicating factors. Conclusions: Many aspects of suboptimal cystitis management were identified (e.g. unnecessarily broad spectra agents, too long antibiotic courses). In this study, patient characteristics has weakly influenced fluoroquinolone prescribing. Based on these results there is considerable room for improvement in primary care antibiotic therapy of cystitis in Hungary.

Urinary Tract Infections in Men in Primary Care in Catalonia, Spain

“…UTIs are usually treated with quinolones, with an average duration of 14 days. This trend in the use of fluoroquinolones has also been observed in PHC in France and Hungary [34,37]. However, in other countries, such as the UK and Sweden, the use of flu-oroquinolones is lower [11,38], or UTIs are treated with other types of antibiotics, as in Norway [33].…”

Susceptibility to first choice antimicrobial treatment for urinary tract infections to Escherichia coli isolates from women urine samples in community South Brazil

“…Quinolones are the most frequently selected antimicrobials for treating uncomplicated UTIs in many countries. 18 , 19 Risk factors associated with resistance to this antimicrobial class include patients older than 60 years of age, presence of obstructive uropathy, recurrent UTI history, as well as the use of quinolones in the past three months. 19 , 20 , 21 …”

Az antibiotikum ambuláns alkalmazásának jellemzői és tendenciái Magyarországon (2010–2019)

“…A széles spektrumú bétalaktámok és a fluorokinolo nok magas relatív hazai felhasználása arra enged követ keztetni, hogy az ambuláns ellátásban gyakori, így az ambuláns antibiotikumfelhasználás szempontjából jelen tős légúti és húgyúti fertőzések kezelése a korábbi hazai felmérésekhez hasonlóan [27][28][29] továbbra is szubopti mális hazánkban.…”