Prescribing Patterns for Patients with Urolithiasis in Emergency Departments: Comparative Analysis of Local Practice versus Evidence-Based Guidelines (2023)
Abstract
Background:
Kidney stones (urolithiasis) are a common urological emergency requiring symptom management and evidence-based pharmacotherapy. Prescribing practices often deviate from guideline recommendations, potentially contributing to antimicrobial resistance and unnecessary medication exposure.
Objective:
This retrospective, descriptive study evaluated prescribing patterns for renal colic in two Iranian emergency departments (EDs), comparing them with international (AUA, EAU) and regional (Asian) guidelines to identify opportunities for evidence-based optimization.
Method:
This cross-sectional study included 168 patients diagnosed with renal colic at Hazrat Rasul Akram Hospital (primary site) and Firouzgar Hospital during 2023. Data were collected using a standardized checklist capturing demographics, stone characteristics, and medication prescriptions. Descriptive statistical analysis was performed using SPSS version 26.
Results:
Of 168 patients (57.7% male, mean age 37.8 ± 11.2 years), all received analgesics (100%). Antispasmodics were prescribed to 75.6% (primarily tamsulosin, 7%), antibiotics to 66.1% (ciprofloxacin 3.9%, amoxicillin 3.4%), H2 receptor antagonists/proton pump inhibitors (PPIs) to 58.9% (famotidine 5.3% [H2 antagonist], pantoprazole 4.8% [PPI]), and urinary alkalinizers to 57.1% (citrate 7.3%). Stone characteristics: predominantly 5–10 mm (85.1%), located in kidney (45.1%), ureter (38.1%), or ureterovesical junction (16.8%).
Conclusion:
While analgesic…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 168 participants or records.
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