Drug utilization pattern in urinary tract infections: A retrospective study

Urinary tract infections (UTI) are a frequent problem in primary care; consequently most cases are considered uncomplicated UTI. Etiology is influenced by factors such as age, diabetes, spinal cord injury, urinary catheterization, and other factors. Escherichia coli cause 80-85% of acute episodes of uncomplicated cystitis. Staphylococcus saprophyticus, proteus mirabilis, streptococcus agalactiae and klebsiella species are responsible for most of the remaining episodes. The empirical treatment of UTI requires constant updating of the antibiotic sensitivity of the main uropathogens of the area, country or institution. The study was designed as a retrospective study in 300 patients of mild to moderate Urinary Tract Infection. The case record files were retrieved from the medical records department based on the ICD-10 disease coding. The demographic were recorded. Total admissions, first admission and readmissions were identified and medication status of all patients at admission and at discharge was ascertained. Comparison of various groups of drugs prescribed in 4 major groups (1-20 years, 21-40 years, 41-60 years, >60 years) of patients on admission and on discharge. A total of 300 patients were included in the study, out of which 147 were males and 153 were females. The mean duration of hospital stay was 4.3 days and with a minimum duration of two days hospitalization and maximum of 10 days hospitalization. 30 % admitted patients receive combination of two antibiotics (cephalosporin+ aminoglycoside) as a part of treatment and 17 % received a combination of 3 antibiotic(cephalosporin + aminoglycoside + penicillin) while, 53 % patient managed with mono therapy (cephalosporin). 60 % of patients received cephalosporin at discharge, 28% patients were asked to continue with aminoglycoside. The study shows that though use of cephalosporin as first line therapy recommendations may change, clinical practice may still be affected by factors other than the decision of ability to diagnose UTI. There is an increased use of cephalosporin as first line drugs, Irrespective of the causative agent for UTI, which is an unhealthy practice. The use of cephalosporin for all types of UTI is also on the increased. These results should inform education of health professionals and rational drug use policies to reduce poly-pharmacy.