Disclosures: Butler reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
March 16, 2021
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Women with UTIs often receive inappropriate antibiotics, especially in rural areas

Disclosures: Butler reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
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Nearly half of women with uncomplicated UTIs received inappropriate antibiotics, and more than a quarter received treatment for an inappropriately long duration, according to a recent study.

Additionally, researchers found that rural women were more likely to receive an inappropriate agent compared with women in urban settings.

Uncomplicated UTI infographic
Source: Clark AW, et al. Infect Control Hosp Epidemiol. 2021;doi:10.1017/ice.2021.21.

“Antimicrobial stewardship programs are needed to improve outpatient antibiotic prescribing and improve health outcomes,” Anne M. Butler, PhD, assistant professor of medicine in the division of infectious diseases and the division of public health sciences at Washington University in St. Louis, told Healio. “Given that uncomplicated UTIs are one of the most common indications for antibiotic prescribing in otherwise healthy populations, we wanted to identify targets for interventions designed to improve guideline adherence.”

Using the IBM MarketScan Commercial Database, Butler and colleagues investigated trends and risks of inappropriate antibiotic use by agent and duration among women in the United States from 2010 to 2015. The study included commercially insured women aged 18 to 44 years with uncomplicated UTIs who were prescribed an oral antibiotic agent. The researchers classified antibiotic agents and durations as appropriate vs. inappropriate based on clinical guidelines.

Anne M. Butler

Of the 670,450 women with uncomplicated UTIs in the study, 46.7% received inappropriate antibiotic agents, and 76.1% received antibiotic prescriptions for inappropriate durations. Researchers added that compared with urban women, rural women were more likely to receive prescriptions with inappropriately long durations (adjusted RR = 1.1; 95% CI, 1.1-1.1), which the study demonstrated was consistent across all subgroups.

“We observed rural-urban differences in receipt of antibiotic prescriptions for inappropriate durations, wherein rural women were more likely to receive inappropriately long durations,” Butler said. “These differences in inappropriate duration were consistent across antibiotic agents, geographic regions, and provider specialties. Overall, we observed a slight decline in inappropriate UTI antibiotic use both by agent and duration over time.”