[Appropriateness of empiric antibiotic therapy in urinary tract infection in emergency room]

Rev Clin Esp. 2010 Jan;210(1):11-6. doi: 10.1016/j.rce.2009.06.009. Epub 2010 Jan 9.
[Article in Spanish]


Introduction: To describe characteristics of urinary tract infections attended in an Emergency Department. To assess antibiotic prescription and inappropriate treatment implications.

Methods: Adults patients attended in an Emergency Department during 2 months with UTI confirmed with urocultive were included. Appropriate antibiotic treatment was considered if the first antibiotic used was sensitive. We compared patients with appropriate and inappropriate antibiotic treatment. A logistic regression was performed to evaluate variables associated to inappropriate antibiotic treatment.

Results: A total of 151 patients were included (61% women, 67.1[22.3] years). Comorbidity was present in 63% of patients. Urinary sepsis was the most frequent diagnosis (32.5%). E coli was isolated in 65.6% of cases, and 10% presented bacteremia. Percentage of inappropriate antibiotic treatment was 20.5. It was associated (uncontrolled analysis) with male gender, elder patients, recent urinary simptoms, urologic manipulation more than 1 month ago, previous antibiotic use (especially ciprofloxacin or amoxicillin-clavulanate) and presentation with urinary sepsis. Logistic regression analysis showed association only with age (HR 0.978 per year, CI95% 0.957-1, p=0.029) and previous antibiotic use (HR 0.298, CI95% 0.098-0.901, p=0.05). Patients with inappropriate antibiotic treatment did not have higher mortality.

Conclusions: Inappropriate antibiotic treatment for UTI in Emergency Department is relatively frequent and it is associated to older age and previous antibiotic use.

Publication types

  • Comparative Study
  • English Abstract
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use*
  • Drug Prescriptions / standards
  • Emergency Service, Hospital
  • Emergency Treatment*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Urinary Tract Infections / drug therapy*
  • Young Adult


  • Anti-Bacterial Agents