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Doctors Treat Female UTIs with Wrong Antibiotics Nearly Half the Time, Study Finds

By Sandee LaMotte via CNN

At least 50% of adult women report having at least one urinary tract infection in their lives, according to the World Health Organization, making that painful disorder one of the most common and collectively expensive types of infection in the world.


A 2011 report by WHO found UTIs contributed to over 8 million office visits and over 1 million hospitalizations, for an overall annual cost of over $1 billion.


Now, a new study has found that doctors gave the wrong antibiotics to nearly half of 670,400 people diagnosed with a UTI. In addition, over three-quarters of those women received antibiotic prescriptions for longer than medically necessary. Long treatment durations -- surpassing clinical guidelines -- were more common in rural than urban areas, according to the study published Wednesday in the journal Infection Control & Hospital Epidemiology of The Society for Healthcare Epidemiology of America.

Overprescribing antibiotics is a leading cause of the growing problem of antibiotic resistance for many common infections. In the United States, someone dies every 15 minutes from a "super bug" that has become resistant to antibiotics.


"Inappropriate antibiotic prescriptions for uncomplicated urinary tract infections are prevalent and come with serious patient- and society-level consequences," said lead author Anne Mobley Butler, an assistant professor of medicine and surgery at Washington University School of Medicine in St. Louis, in a statement.


"Accumulating evidence suggests that patients have better outcomes when we change prescribing from broad-acting to narrow-spectrum antibiotics and from longer to shorter durations," Butler said.

"Promoting optimal antimicrobial use benefits the patient and society by preventing avoidable adverse events, microbiome disruption, and antibiotic-resistant infections," she added.


Analysis of insurance data

Researchers analyzed insurance claims for women between the ages of 18 and 44 who were diagnosed with a common form of urinary tract infection between April 2011 and June 2015.


Antibiotic prescriptions given to those women were compared to current clinical guidelines. The researchers found some 47% of the prescriptions were written for antibiotics that didn't meet medical recommendations. Women who lived in rural areas were more likely to be told to take that antibiotic for an "inappropriately long duration of therapy than urban patients," the study found, although 76% of all the women in the study were on antibiotics too long.


It's possible, the study said, that rural doctors may not be as aware of current antibiotic treatment guidelines, or perhaps gave their patients more antibiotics because of the distance needed to travel to and from the clinic in case symptoms persisted.


Symptoms and causes

Urinary tract infections can happen to both men and women of any age, but are more common in women and girls, who have shorter urethras that are closer to the rectum, making it easier for bacteria to infect the urinary tract.


Women are more likely to develop a UTI if you engage in sexual activity, especially with a new sexual partner, and forget to urinate after intercourse, according to the US Centers for Disease Control and Prevention.


Other risk factors include a history of UTIs, menopause, pregnancy, the use of spermicides that might change vaginal bacteria and an enlarged prostate.


Age is a factor as well -- many children get UTIs while potty training because they do not know which direction to wipe -- while the elderly are at high risk because they have more problems emptying their bladder completely as they age.


Symptoms of UTIs include frequent urination that is painful or burns, bloody urine, low stomach cramps and the need to urinate even after having just gone.


A kidney infection is another type of UTI, which can be more serious if not treated. Symptoms include fever, chills, nausea or vomiting and lower back pain.


Symptoms of a UTI can mimic those of many sexually transmitted diseases, so a urine test may be needed to identify the cause. Because UTIs are caused by bacteria, they are treated with antibiotics.

 

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