BACKGROUND: In view of the currently increasing rates of antibiotic resistance, we studied the factors that affect the prescribing of specific antibiotics for uncomplicated cystitis in outpatient care. METHODS: A nationwide cross-sectional survey of physicians in private practice in various specialties (internal medicine, general medicine, surgery, obstetrics/gynecology, child and adolescent medicine, otorhinolaryngology, dermatology, urology) was carried out in 2008. The sample was derived from the German state directories of medical specialists. RESULTS: 1810 (60%) of the physicians surveyed reported that they made decisions about antibiotic treatment every day, with uncomplicated urinary tract infection as the most common diagnosis (715 physicians). The antibiotics that they prescribed most commonly for it were cotrimoxazole (61%) and fluoroquinolones (21%). The following factors were significantly associated with a preference for fluoroquinolones: being a gynecologist (odds ratio [OR] 0.47, 95% confidence interval [CI] 0.27-0.80), location of practice in the former East Germany (OR 2.01, CI 1.16-3.46), a treatment strategy incorporating a switch from empirical to targeted treatment (OR 1.72, CI 1.02-2.90), and the stated intention of avoiding inconvenience to the patient (OR 2.14, CI 1.25-3.68). DISCUSSION: Fluoroquinolones are no longer recommended as the drug of first choice for uncomplicated urinary tract infections because of the development of resistance, but are still commonly prescribed for it. ARS (Antibiotic Resistance Surveillance in Germany) publishes current regional and patient-group-specific resistance rates to promote good clinical practice and improve prescribing behavior.
BACKGROUND: In view of the currently increasing rates of antibiotic resistance, we studied the factors that affect the prescribing of specific antibiotics for uncomplicated cystitis in outpatient care. METHODS: A nationwide cross-sectional survey of physicians in private practice in various specialties (internal medicine, general medicine, surgery, obstetrics/gynecology, child and adolescent medicine, otorhinolaryngology, dermatology, urology) was carried out in 2008. The sample was derived from the German state directories of medical specialists. RESULTS: 1810 (60%) of the physicians surveyed reported that they made decisions about antibiotic treatment every day, with uncomplicated urinary tract infection as the most common diagnosis (715 physicians). The antibiotics that they prescribed most commonly for it were cotrimoxazole (61%) and fluoroquinolones (21%). The following factors were significantly associated with a preference for fluoroquinolones: being a gynecologist (odds ratio [OR] 0.47, 95% confidence interval [CI] 0.27-0.80), location of practice in the former East Germany (OR 2.01, CI 1.16-3.46), a treatment strategy incorporating a switch from empirical to targeted treatment (OR 1.72, CI 1.02-2.90), and the stated intention of avoiding inconvenience to the patient (OR 2.14, CI 1.25-3.68). DISCUSSION: Fluoroquinolones are no longer recommended as the drug of first choice for uncomplicated urinary tract infections because of the development of resistance, but are still commonly prescribed for it. ARS (Antibiotic Resistance Surveillance in Germany) publishes current regional and patient-group-specific resistance rates to promote good clinical practice and improve prescribing behavior.
Authors: K De With; H Schröder; E Meyer; K Nink; S Hoffmann; M Steib-Bauert; R Kämmerer; S Ruess; F D Daschner; W V Kern Journal: Dtsch Med Wochenschr Date: 2004-09-17 Impact factor: 0.628
Authors: Kalpana Gupta; Thomas M Hooton; Kurt G Naber; Björn Wullt; Richard Colgan; Loren G Miller; Gregory J Moran; Lindsay E Nicolle; Raul Raz; Anthony J Schaeffer; David E Soper Journal: Clin Infect Dis Date: 2011-03-01 Impact factor: 9.079
Authors: A R Ronald; L E Nicolle; E Stamm; J Krieger; J Warren; A Schaeffer; K G Naber; T M Hooton; J Johnson; S Chambers; V Andriole Journal: Int J Antimicrob Agents Date: 2001-04 Impact factor: 5.283
Authors: Luke Johnson; Allison Sabel; William J Burman; Rachel M Everhart; Marcie Rome; Thomas D MacKenzie; Jeanne Rozwadowski; Philip S Mehler; Connie Savor Price Journal: Am J Med Date: 2008-10 Impact factor: 4.965
Authors: Gabriele Gradl; Martina Teichert; Marita Kieble; Johanna Werning; Martin Schulz Journal: Pharmacoepidemiol Drug Saf Date: 2018-09-28 Impact factor: 2.890