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Antibiotics 2016, 5(3), 31; doi:10.3390/antibiotics5030031

Reconsultation and Antimicrobial Treatment of Urinary Tract Infection in Male and Female Patients in General Practice

1
Discipline of General Practice, School of Medicine, National University of Ireland Galway (NUIG), Galway, Ireland
2
Discipline of Bacteriology, School of Medicine, National University of Ireland Galway (NUIG), Galway, Ireland
3
Department of Medical Microbiology, University Hospital Galway (UHG), Galway, Ireland
*
Author to whom correspondence should be addressed.
Academic Editor: Christopher C. Butler
Received: 10 June 2016 / Revised: 30 August 2016 / Accepted: 2 September 2016 / Published: 15 September 2016
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Abstract

Current antimicrobial prescribing guidelines indicate that male and female patients with urinary tract infections (UTIs) should be treated with same antimicrobials but for different durations. The aim of this study was to explore the differences in reconsultations and antimicrobial prescribing for UTI for both males and females. A total of 2557 adult suspected UTI patients participating in the Supporting the Improvement and Management of Prescribing for urinary tract infection (SIMPle) study from 30 general practices were analyzed. An antimicrobial was prescribed significantly more often to females (77%) than males (63%). Nitrofurantoin was prescribed more often for females and less often for males (58% vs. 41%), while fluoroquinolones were more often prescribed for males (11% vs. 3%). Overall, reconsultation was 1.4 times higher in females, and if the antimicrobial prescribed was not the recommended first-line (nitrofurantoin), reconsultation after empirical prescribing was significantly higher. However, the reconsultation was similar for males and females if the antimicrobial prescribed was first-line. When a urine culture was obtained, a positive culture was the most important predictor of reconsultation (Odds ratio 1.8 (95% CI 1.3–2.5)). This suggests, when prescribing empirically, that male and female UTI patients should initially be treated with first-line antimicrobials (nitrofurantoin) with different durations (50–100 mg four times daily for three days in females and seven days for males). However, the consideration of a culture test before prescribing antimicrobials may improve outcomes. View Full-Text
Keywords: urinary tract infection; reconsultation; general practice; antimicrobial prescribing; treatment; culture test; male and female urinary tract infection; reconsultation; general practice; antimicrobial prescribing; treatment; culture test; male and female
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MDPI and ACS Style

Tandan, M.; Duane, S.; Cormican, M.; Murphy, A.W.; Vellinga, A. Reconsultation and Antimicrobial Treatment of Urinary Tract Infection in Male and Female Patients in General Practice. Antibiotics 2016, 5, 31.

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