ArticleOpen forum infectious diseases2015
Low Concordance With Guidelines for Treatment of Acute Cystitis in Primary Care.
Article in Open forum infectious diseases, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
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Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The effects of information technology interventions for optimizing antibiotic prescribing in urinary tract infections: a systematic review.BMC infectious diseases · 2025Pooled it
- Operational Research Improves Compliance with Treatment Guidelines for Empirical Management of Urinary Tract Infection: A Before-and-After Study from a Primary Health Facility in Ghana.Tropical medicine and infectious disease · 2025Article
- Machine learning for the prediction of urosepsis using electronic health record data.PLOS digital health · 2025Article
- Duration of antibiotic treatment for respiratory tract infections in primary care.JAC-antimicrobial resistance · 2025Article
- Impact of an evidence-based order panel on antibiotic prescribing in ambulatory patients with cystitis.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Antibiotic Stewardship Interventions for Urinary Tract Infections in Outpatient Settings: A Narrative Review.Infectious disease clinics of North America · 2024Review
- Situations predisposing primary care patients to use antibiotics without a prescription in the United States.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- Longitudinal Patterns in Testosterone Prescribing After US FDA Safety Communication in 2014.Joint Commission journal on quality and patient safety · 2023Article
- Increase in the community circulation of ciprofloxacin-resistant Escherichia coli despite reduction in antibiotic prescriptions.Communications medicine · 2023Article
- Development and evaluation of a continuous quality improvement programme for antimicrobial stewardship in six hospitals in Uganda.BMJ open quality · 2023Article
- Increase in the Rate of Gut Carriage of Fluoroquinolone-Resistant Escherichia coli despite a Reduction in Antibiotic Prescriptions.Research square · 2023Article
- Article
- Compliance to Guidelines in Prescribing Empirical Antibiotics for Individuals with Uncomplicated Urinary Tract Infection in a Primary Health Facility of Ghana, 2019-2021.International journal of environmental research and public health · 2022Article
- Assessment of the Compliance of Cystitis Management According to French Recommendations through the Analysis of Prescriptions Collected in Community Pharmacies.Antibiotics (Basel, Switzerland) · 2022Article
- Impact of Education and Data Feedback on Guideline-Concordant Prescribing for Urinary Tract Infections in the Outpatient Setting.Open forum infectious diseases · 2022Article
- Relationship between the appropriateness of antibiotic treatment and clinical outcomes/medical costs of patients with community-acquired acute pyelonephritis: a multicenter prospective cohort study.BMC infectious diseases · 2022Article
- Analysis of recurrent urinary tract infection management in women seen in outpatient settings reveals opportunities for antibiotic stewardship interventions.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2022Article
- The Five Ds of Outpatient Antibiotic Stewardship for Urinary Tract Infections.Clinical microbiology reviews · 2021Review
- Rural-urban differences in antibiotic prescribing for uncomplicated urinary tract infection.Infection control and hospital epidemiology · 2021Observational
- Case-based audit and feedback around a decision aid improved antibiotic choice and duration for uncomplicated cystitis in primary care clinics.Family medicine and community health · 2021Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
Background. The updated 2010 Infectious Diseases Society of America guidelines recommended 3 first-line therapies for uncomplicated cystitis: nitrofurantoin, trimethoprim-sulfamethoxazole (TMP-SMX), and fosfomycin, while fluoroquinolones (FQs) remained as second-line agents. We assessed guideline concordance for antibiotic choice and treatment duration after introduction of the updated guidelines and studied patient characteristics associated with prescribing of specific antibiotics and with treatment duration. Methods. We used the Epic Clarity database (electronic medical record system) to identify all female patients aged ≥18 years with uncomplicated cystitis in 2 private family medicine clinics in the period of 2011-2014. For each eligible visit, we extracted type of antibiotic prescribed, duration of treatment, and patient and visit characteristics. Results. We included 1546 visits. Fluoroquinolones were the most common antibiotic class prescribed (51.6%), followed by nitrofurantoin (33.5%), TMP-SMX (12.0%), and other antibiotics (3.2%). A significant trend occurred toward increasing TMP-SMX and toward decreasing nitrofurantoin use. The duration of most prescriptions for TMP-SMX, nitrofurantoin, and FQs was longer than guidelines recommendations (longer durations were prescribed for these agents in 82%, 73%, and 71% of the prescriptions, respectively). No patient or visit characteristic was associated with use of specific antibiotics. Older age and presence of diabetes were independently associated with longer treatment duration. Conclusions. We found low concordance with the updated guidelines for both the choice of drug and duration of therapy for uncomplicated cystitis in primary care. Identifying barriers to guideline adherence and designing interventions to decrease overuse of FQs may help preserve the antimicrobial efficacy of these important antimicrobials.
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