Author: Claire Baizet
Antibiotic prescription (ATB) in France is inappropriate in 20 to 50% of cases according to the literature. Urinary tract infections (UTIs) are the second most common site of infection in terms of consultations and antibiotic prescriptions in emergency departments. The aim of our study was to evaluate our practices concerning the management of UTIs.
Material and method: Setting up of a monocentric retrospective observational descriptive study between January 1 and December 31, 2014 at the Cayenne Hospital Center. Inclusion criteria were patients older than 15 years and 3 months with a diagnosis of UTI and a positive UEC or a diagnosis confirmed by a specialist.
The primary endpoint was the adequacy of current UTI management practices with the 2008 national recommendations.
Results: 289 UTIs were studied. 28.4% were cystitis, 57.4% pyelonephritis (PNA) and 14.2% male UTIs. The compliance rate for prescribing biological tests (standard blood tests/blood cultures/urine dipstick/ECBU) was 71.7% for cystitis, 66.4% for PNA and 83.8% for male UTI. The compliance rate for TBA prescriptions was 52.3% for all criteria combined. Factors associated with non-compliance of TBA prescriptions were the presence of comorbidities p=0.001 OR 0.5 (0.3-0.9) and previous UTI p=0.007 0R 0.4 (0.2-0.8).
Conclusion: Compliance rates remain poor. In order to improve our practices, an update of knowledge should be planned in the emergency room of Cayenne to reduce patient morbidity and slow down the emergence of resistance.
