Community Urinary Tract Infections: Guideline Adjustment
Abstract
Introduction: Urinary tract infections are very common in the community and are one of the most common reasons for antibiotic prescription. Our objective was to identify the most frequent microorganisms present in urine cultures in Primary Health Care, at a Local Health Unit and their sensitivity profile to some antibiotics.Methods: Observational and retrospective study based on bacteriological identification in urine cultures obtained between January/2020 and December/2021. Individuals of both genders and ages 15 and over were included.Results: The total number of urine cultures obtained was 2788, 83% from female patients, and 17% from males. In males, unlike females, there were no significant differences between age groups regarding the isolates agents. The most frequently isolated agent in both sexes was Escherichia coli (64.89%), and its sensitivity to fosfomycin is over 98% in all age groups, and equal to or less than 75% to amoxicillin-clavulanic acid.Conclusion: Empirical treatment of uncomplicated cystitis should target Escherichia coli. Amoxicillin-clavulanic acid should not be considered as empirical treatment, except in patients with a history of lithiasis. Pivmecillinam would be a viable option if available for prescription in the community. Antibiotic selection should be appropriate and in accordance with local resistance patterns and based on data from more recent studies, since the variability of antibiotic sensitivities can change.
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