Clinical AdvisorMost Uncomplicated UTIs Not Treated According to IDSA Guidance, Study Finds

Of the analyzed patients, a mere 16.9% received the IDSA-recommended treatment.

A study showcased at the American Academy of Physician Associates (AAPA) national conference divulges a concerning trend in the treatment approach for uncomplicated urinary tract infections (UTIs) at the emergency department, bringing the adherence to IDSA guidelines into question.

Key Points:

• Most patients with uncomplicated UTIs presenting to the emergency department are not receiving treatment recommended by the IDSA guidelines.
• First-line treatment as per IDSA is 100mg nitrofurantoin given twice daily for 5 days.
• In a retrospective study of 150 patients, only 79 met the inclusion criteria and were included in the final analysis.
• Even when nitrofurantoin was administered (64.6% of patients), the duration was incorrect (7 days instead of 5) in 76.5% of cases.
• Electronic medical records (EMRs) may be contributing to the problem, being preset to suggest 100mg nitrofurantoin twice daily for 7 days.

Additional Points:

• The most common alternative to nitrofurantoin was cephalexin (500 mg).
• Despite IDSA recommendations, 70.9% of patients received a urine culture; 36.7% indicated E. coli, 11.4% had mixed flora, and 7.6% showed no growth.

Conclusion:

• Adherence to IDSA guidelines for uncomplicated UTI treatment in emergency departments is low, pointing to a need for improvement, potentially starting with correction of EMR presets.

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Did You Know?
UTIs are the most common bacterial infection, affecting about 50% of women at least once during their lifetime.