Management of urinary tract infections : a retrospective review in the local urology unit

Abstract

BACKGROUND: Urinary Tract Infections (UTIs) affect an estimated 150 million people per annum worldwide and can be classified into simple and complicated as well as upper and lower. The primary method of diagnosing a UTI is via an adequate and timely sample of urine for culture and sensitivity. The main aims of this retrospective audit were to determine the type of UTIs admitted to the Urology unit at Mater Dei Hospital, the rate of utilization and timing of urine and blood cultures, the empirical antimicrobials prescribed and the rate of resistance to these antimicrobials, especially the rate of Fluoroquinolone resistance.

METHOD: In this retrospective audit, patients admitted with a UTI to the Urology Department during a 4-week period were included in the study.

RESULTS: The majority of patients included in this study were diagnosed with a complicated UTI. A urine sample for culture and sensitivity was taken on the first day of admission in most cases, with Escherichia coli being the commonest cultured organism. Resistance to Fluoroquinolones was exhibited in 36% of cases. Piperacillin/Tazobactam was the empirical antibiotic of choice in 59.4% of the patients with the majority showing sensitivity to it. Most patients were discharged with an outpatient follow-up however, only 35% of patients had further imaging studies.

CONCLUSION: International guidelines regarding diagnosing and treating UTIs are adhered to at large. However, local guidelines are required to improve empirical antimicrobial choice and prescription according to the local prevalent organisms and their sensitivities.