Outpatient Prescribing Patterns for Uncomplicated Cystitis in Premenopausal Women With and Without an Allergy to Guideline-Recommended Antimicrobials: A Retrospective Analysis
Abstract
Objective: To determine if premenopausal women 18 to 50 years of age with uncomplicated cystitis who have an allergy to a guideline-recommended antimicrobial agent are less likely to receive guideline-preferred treatment compared to women without an allergy.
Methods: An electronic medical record report was used to identify females between the ages of 18-50 with a diagnostic code for acute uncomplicated cystitis at outpatient visits between December 1, 2017, through December 31, 2021. Patients with complicated urinary tract infections or pyelonephritis were excluded. After identifying the eligible encounters, a retrospective chart review was used to collect demographic information, known antimicrobial allergies, urinalysis and culture results, and prescribed antimicrobials. The primary outcome was a receipt of a guideline-preferred antimicrobial. Secondary outcomes included fluoroquinolone utilization and resistance patterns, as well as subgroup analyses of patients with specific allergies to guideline-preferred agents.
Results: A total of 496 patient encounters were screened for inclusion, with 165 meeting the inclusion criteria. Of those, 38 encounters were identified as having a documented antimicrobial allergy (23%) to a guideline-recommended agent. Demographic and clinical characteristics were similar between patients with and without antimicrobial allergies, except for race. Beta-lactam allergies were the most frequently documented antimicrobial allergy. All 165…
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