Urinary tract infections (UTIs) in primary care have national treatment guidelines to improve antibiotic efficacy and lessen antibiotic resistance prevalence. These guidelines may not be as helpful in high-risk areas for antibiotic resistance, such as areas with heavy agriculture or those that span international borders. Women experiencing symptoms of an acute UTI visited general practitioners (GPs) in the Westland area, a highly agricultural region, and their midstream urine samples were microbiologically analyzed. Data on patient characteristics, symptoms, and past and present antibiotic treatment were also gathered. Information on antibiotic resistance was compared to the National Nivel. About  247 (or 80%) of the 310 women who presented with symptoms of a simple UTI actually did have an E.coli UTI, as determined by culture. Overall, 148 patients (48%) received an empirical antibiotic regimen, 7% female patients with a negative pee culture, and 52% female patients with a positive urine culture. Multiple symptoms led doctors to prescribe antibiotics, but past travel or medication use for a urinary tract infection played no role. In 98% of patients, the uropathogens detected were successfully treated with the initial round of empiric antibiotics. The prevalence of extended-spectrum β-lactamase (ESBL) was 3.4% in the study compared to 0.1%, 1%, and 2.2% in the national data from 2004, 2009, and 2014, respectively, but the prevalence of co-amoxiclav resistance was greater (22% vs. 12%, 13%, and 9%, respectively). Women with uncomplicated UTIs were not affected by environmental and sociodemographic risk factors for antibiotic resistance in their empiric choice of medications or susceptibility to antibiotics recommended by national guidelines.


Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-022-01840-6