Antimicrobial resistance surveillance in urinary tract infections in primary care

J Antimicrob Chemother. 2016 Oct;71(10):2723-8. doi: 10.1093/jac/dkw223. Epub 2016 Jun 26.


Urinary tract infection (UTI) is one of the most common reasons for prescription of antimicrobials in primary care. Laboratory resistance data produced because of specimen analysis to support individual patient diagnosis and management are generalized to guide empirical therapy across a wider population, but are limited by bias toward certain patient groups and almost certainly overestimate the incidence of resistance. Other methods of surveillance are required to provide unbiased estimates of antimicrobial resistance, but need to be sustainable. Sentinel surveillance, perineal flora sampling and development of clinical algorithms to support more stratified and personalized antimicrobial prescribing need to be further investigated. Linkages to prescription and clinical outcome data are essential if the burden of antimicrobial resistance in UTI is to be understood. Pilot and feasibility studies need to be performed to establish the best approach to enhancing the quality, relevance and sustainability of antimicrobial resistance surveillance in community-acquired UTI.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Clinical Decision-Making
  • Community-Acquired Infections / drug therapy
  • Community-Acquired Infections / microbiology
  • Drug Prescriptions*
  • Drug Resistance, Multiple, Bacterial*
  • Female
  • Humans
  • Primary Health Care
  • Sentinel Surveillance
  • Urinary Tract Infections / diagnosis
  • Urinary Tract Infections / drug therapy*
  • Urinary Tract Infections / microbiology*
  • Young Adult


  • Anti-Bacterial Agents