Survey of antibiotic prescribing in a district general hospital. III. Urinary tract infection.

A 28 day survey of all antibiotic prescriptions in a district general hospital included a brief interview with the prescriber of each prescription. Fifty-nine antibiotic courses were stated by the prescriber to be for the treatment of urinary tract infection (UTI). Urine specimens from all patients treated for UTI were sent to the laboratory for bacteriological examination. 29 patients' treatment was started as the result of isolation of bacteria from the urine. 20 of the patients also had symptoms suggestive of UTI. 4 patients were treated solely because bacteria had been isolated from "routine" catheter stream urine specimens. 7 patients were treated for UTI despite the availability, at the time of prescription, of a laboratory report stating that bacteria had not been isolated from the urine. 19 patients' treatment was started before the results of bacteriological tests were available. By combining information about bacteriological examination of the urine specimens and clinical details recorded during the interview with the prescribed, it was considered that both initiation and continuation of antibiotic treatment was justified for 28/55 patients and that either initiation or continuation of treatment was unjustified for 27/55 patients.