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Tandan M, Duane S, Cormican M, et al. Reconsultation and Antimicrobial Treatment of Urinary Tract Infection in Male and Female Patients in General Practice. Antibiotics (Basel). 2016;5(3)doi: 10.3390/antibiotics5030031.
Tandan, M., Duane, S., Cormican, M., Murphy, A. W., & Vellinga, A. (2016). Reconsultation and Antimicrobial Treatment of Urinary Tract Infection in Male and Female Patients in General Practice. Antibiotics (Basel, Switzerland), 5(3), . https://doi.org/10.3390/antibiotics5030031
Tandan, Meera, et al. "Reconsultation and Antimicrobial Treatment of Urinary Tract Infection in Male and Female Patients in General Practice." Antibiotics (Basel, Switzerland) vol. 5,3 (2016). doi: https://doi.org/10.3390/antibiotics5030031
Tandan M, Duane S, Cormican M, Murphy AW, Vellinga A. Reconsultation and Antimicrobial Treatment of Urinary Tract Infection in Male and Female Patients in General Practice. Antibiotics (Basel). 2016 Sep 15;5(3). doi: 10.3390/antibiotics5030031. PMID: 27649253; PMCID: PMC5039527.
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Antibiotics (Basel). 2016 Sep 15;5(3). doi: 10.3390/antibiotics5030031.

Reconsultation and Antimicrobial Treatment of Urinary Tract Infection in Male and Female Patients in General Practice.

Antibiotics (Basel, Switzerland)

Meera Tandan, Sinead Duane, Martin Cormican, Andrew W Murphy, Akke Vellinga

Affiliations

  1. Discipline of General Practice, School of Medicine, National University of Ireland Galway (NUIG), Galway, Ireland. [email protected].
  2. Discipline of General Practice, School of Medicine, National University of Ireland Galway (NUIG), Galway, Ireland. [email protected].
  3. Discipline of Bacteriology, School of Medicine, National University of Ireland Galway (NUIG), Galway, Ireland. [email protected].
  4. Department of Medical Microbiology, University Hospital Galway (UHG), Galway, Ireland. [email protected].
  5. Discipline of General Practice, School of Medicine, National University of Ireland Galway (NUIG), Galway, Ireland. [email protected].
  6. Discipline of General Practice, School of Medicine, National University of Ireland Galway (NUIG), Galway, Ireland. [email protected].
  7. Discipline of Bacteriology, School of Medicine, National University of Ireland Galway (NUIG), Galway, Ireland. [email protected].

PMID: 27649253 PMCID: PMC5039527 DOI: 10.3390/antibiotics5030031

Abstract

Current antimicrobial prescribing guidelines indicate that male and female patients with urinary tract infections (UTIs) should be treated with same antimicrobials but for different durations. The aim of this study was to explore the differences in reconsultations and antimicrobial prescribing for UTI for both males and females. A total of 2557 adult suspected UTI patients participating in the Supporting the Improvement and Management of Prescribing for urinary tract infection (SIMPle) study from 30 general practices were analyzed. An antimicrobial was prescribed significantly more often to females (77%) than males (63%). Nitrofurantoin was prescribed more often for females and less often for males (58% vs. 41%), while fluoroquinolones were more often prescribed for males (11% vs. 3%). Overall, reconsultation was 1.4 times higher in females, and if the antimicrobial prescribed was not the recommended first-line (nitrofurantoin), reconsultation after empirical prescribing was significantly higher. However, the reconsultation was similar for males and females if the antimicrobial prescribed was first-line. When a urine culture was obtained, a positive culture was the most important predictor of reconsultation (Odds ratio 1.8 (95% CI 1.3-2.5)). This suggests, when prescribing empirically, that male and female UTI patients should initially be treated with first-line antimicrobials (nitrofurantoin) with different durations (50-100 mg four times daily for three days in females and seven days for males). However, the consideration of a culture test before prescribing antimicrobials may improve outcomes.

Keywords: antimicrobial prescribing; culture test; general practice; male and female; reconsultation; treatment; urinary tract infection

Conflict of interest statement

The authors declare that they have no competing interest.

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