Adherence to Treatment Guidelines in Antibiotic Prescribing for Urinary Tract Infection in a Tertiary Care Hospital
Abstract
Background: Urinary tract infection (UTI) is a common bacterial infection driving widespread antibiotic use. Evidence-based guidelines optimize drug selection, dosage, and duration to improve patient outcomes and curb antimicrobial resistance, yet non-adherence remains common. This study assessed compliance with national treatment guidelines for UTI antibiotic prescribing at a tertiary care hospital in Bangladesh. Methods: This cross-sectional study was conducted from July 2024 to June 2025 at Sylhet MAG Osmani Medical College Hospital. Prescribing data were collected from indoor and outpatient departments of medicine, nephrology, and gynecology. A sample of 322 adult UTI prescriptions was evaluated against the Standard Treatment Guidelines (STG) for Antibiotic Use in Common Infectious Diseases of Bangladesh, analyzing choice, dose, route, and duration. Result: Nitrofurantoin was the most frequent guideline-compliant choice (34.16%). Conversely, Ciprofloxacin (23.91%), Cefuroxime (22.67%), and Ceftriaxone (12.42%) were completely inappropriate selections violating the guidelines. Adherence rates across individual prescribing parameters were uniformly low: appropriate dosing was observed in 125 (38.8%) prescriptions, appropriate route in 125 (38.8%), and appropriate duration in 121 (37.6%) (p < 0.001). Overall, only 121 (37.58%) prescriptions fully adhered to the guidelines, while 201 (62.42%) were non-adherent (p < 0.001). Conclusion: Empirical antibiotic prescribing for…
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Evidence Hub reads this as a cross-sectional. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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