Many women getting wrong antibiotic for UTI, study says
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If you’ve gone to the doctor for a urinary tract infection, or UTI, chances are that you’ve been given the wrong antibiotic or a longer-than-necessary treatment plan.

That’s even more likely if you live in a rural area, researchers say.

A new study of private insurance claims data found that 47% of women were prescribed antibiotics that were outside recommended guidelines and 76% were prescribed those drugs for an inappropriate duration, mostly too long.

Inappropriate use of antibiotics has fueled a surge in drug-resistant bacteria. These germs can spread and cause infections that common antibiotics are unable to cure.

“Inappropriate antibiotic prescriptions for uncomplicated urinary tract infections are prevalent and come with serious patient- and society-level consequences,” said lead author Anne Mobley Butler. She is assistant professor of medicine and surgery at Washington University School of Medicine in St. Louis.

“Our study findings underscore the need for antimicrobial stewardship interventions to improve outpatient antibiotic prescribing, particularly in rural settings,” Butler said in a news release from the Society for Healthcare Epidemiology of America.

Rural patients were more likely to receive a prescription for an inappropriately long duration than urban patients, according to an analysis of geographic data.

The findings come from a look at insurance claims data for 670,400 U.S. women between the ages of 18 and 44. Each was diagnosed with an uncomplicated UTI between April 2011 and June 2015.

The researchers said that they suspect there are two reasons for the disparities between country- and city-dwelling patients.

Rural providers may be less aware of current antibiotic treatment guidelines, the study authors suggested. And urban providers may prescribe a longer course of antibiotics for their patients who live out in the country because of distance barriers in case symptoms persist.

Butler said providers should periodically review clinical practice guidelines, even for common conditions, like urinary tract infections.

“Accumulating evidence suggests that patients have better outcomes when we change prescribing from broad-acting to narrow-spectrum antibiotics, and from longer to shorter duration,” Butler said. “Promoting optimal antimicrobial use benefits the patient and society by preventing avoidable adverse events, microbiome disruption, and antibiotic-resistant infections.”

Further study is needed to understand and improve rural outpatient antibiotic prescribing practices, the researchers noted.

The findings were published recently in the journal Infection Control & Hospital Epidemiology.

More information

The U.S. Centers for Disease Control and Prevention has more on urinary tract infection.

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