Most women receive improper treatment for UTIs, study shows

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It’s a fact that antibiotics do not treat viruses. But what about when they’re improperly prescribed and used?

The latter is the case as shown in a study published Wednesday in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.

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“Inappropriate antibiotic prescriptions for uncomplicated urinary tract infections are prevalent and come with serious patient- and society-level consequences,” the study’s lead author Anne Mobley Butler, Ph.D., said in a news release. “Our study findings underscore the need for antimicrobial stewardship interventions to improve outpatient antibiotic prescribing, particularly in rural settings.”

The observational cohort study reviewed insurance claims data for 670,400 women from age 18 to 44 who received an outpatient diagnosis of uncomplicated urinary tract infection. The date range for the diagnosis was from April 2011 to June 2015. Researchers pinpointed antibiotic prescriptions that had been filled and evaluated adherence to clinical guidelines. Then, they compared the patterns of antibiotic use in rural and urban areas.

It was discovered that inappropriately prescribed antibiotics were common; 47% of prescriptions were written for antibiotics that were not within guideline recommendations. The rates were worse for duration as 76% of antibiotics were written for an inappropriately long duration; almost all of the prescriptions were given for longer than recommended. That was more common among rural patients than urban ones.

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“Accumulating evidence suggests that patients have better outcomes when we change prescribing from broad-acting to narrow-spectrum antibiotics and from longer to shorter durations,” Butler, who is an assistant professor of medicine and surgery at Washington University School of Medicine, St. Louis, said. “Promoting optimal antimicrobial use benefits the patient and society by preventing avoidable adverse events, microbiome disruption, and antibiotic-resistant infections.”

A 2019 study published in the National Center for Integrative Biomedical Informatics reported UTIs are the most common outpatient infections in the country. Aside from a spike in the prevalence of the infection in teens and women ages 14-24, UTIs’ pervasiveness grows with age. Compared to 11% of the general population, the prevalence of UTIs in women over 65 is 20%.

According to the Centers for Disease Control and Prevention, bacteria cause UTIs, which are treated with antibiotics. The Atlanta-based agency cautions, though, that antibiotics can cause side effects any time they are taken. They can range from mild to severe. If you’re taking antibiotics, you should contact your doctor if you develop any reactions.

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