Official websites use. Share sensitive information only on official, secure websites. Urinary tract infections UTI are among the commonest bacterial infections in ambulatory medicine and thus account for a large fraction of outpatient prescriptions for antibiotics. The overall use of antibiotics by the population is a major factor in the development of antibiotic resistance.
Thus, changes in prescribing practices may significantly affect antibiotic resistance rates in the community. Velasco et al. Further goals of the survey were to assess. This underscores the importance of ambulatory medicine as a contributor to overall antibiotic use. Far fewer physicians prescribed penicillins ca. Moreover, the authors found that the following groups of physicians more commonly prescribed fluoroquinolones:.
Interestingly, a microbiological examination of the urine before the initiation of antibiotic treatment does have a small effect on prescribing behavior even for uncomplicated cystitis. It was assumed till now that sensitivity testing in this disease entity generally does not change antibiotic prescribing at all.
The reason for the assumption was that the antibiotic treatment of uncomplicated cystitis, at least with fluoroquinolones or with cotrimoxazole, is generally short-term, lasting only about three days; thus, the treatment is usually over before the resistance pattern of the responsible pathogen has been determined. The survey whose findings are analyzed here by Velasco et al. Important publications on the altered pattern of antibiotic resistance in uncomplicated UTI had already appeared 2 — 4 , but these data were still too new to have been incorporated into the guidelines.
Today, more weight is given to the fact that broad-spectrum antibiotics such as fluoroquinolones or cephalosporins are more likely to have epidemiologic side effects, i. These issues have been taken into account in the interdisciplinary S3 guideline on the treatment of uncomplicated UTI, as reflected in the treatment recommendations 6 :.
