A PROSPECTIVE STUDY OF THE PATTERN OF ANTIMICROBIAL USE IN COMPLICATED URINARY TRACT INFECTIONS IN INPATIENTS IN A TERTIARY CARE HOSPITAL

Abstract

Prescriptions of 100 inpatients with complicated urinary tract infections (cUTIs) were reviewed. The pattern of antimicrobial agent (AMA) use, criteria for selection either empirical or organism specific and any subsequent change in AMA therapy were analyzed. Mean age of patients at presentation was 50.6±11.4 years. There were 44% males and 56% females. Ofloxacin (n=26), ciprofloxacin (n=11), levofloxacin (n=9), ceftriaxone±sulbactam (n=29) and piperacillin+tazobactam (n=8) were the most common first choice AMAs. Aminoglycosides (n=6) and nitroimidazoles (n=12) were add on drugs in some selected cases. In majority of cases (85%), the choice of AMAs was empirical, predominantly as monotherapy (71%) by intravenous route (78%). All AMAs were used in their standard recommended doses and frequency. 78% showed clinical cure at the end of AMA therapy and 22% required change in AMA therapy due to inadequate clinical improvement (n=12) or isolation of drug resistant organism (n=10). Mean duration of AMA therapy was 9.2±2.2 days. Although empirical therapy has shown clinical improvement, evidence of bacteriological cure on urine culture ensures complete cure and prevents persistence or recurrence.