Longer than recommended empiric antibiotic treatment of urinary tract infection in women: an avoidable waste of money.

CONTEXT: Current Israeli guidelines for the empiric treatment of uncomplicated urinary tract infection (UTI) in women recommend nitrofurantoin for 5 days. Some physicians nevertheless opt for ofloxacin, which should be prescribed for 3 days according to universally accepted guidelines. OBJECTIVE: To...

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Publicado en:Journal of Clinical Pharmacy & Therapeutics Vol. 29; no. 1; pp. 59 - 64
Autores principales: Kahan NR, Chinitz DP, Kahan E
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Feb2004
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2004
      vid: 29
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      pub: Wiley-Blackwell
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        106660151
        2004182478
        10.1111/j.1365-2710.2003.00537.x
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        atl: Longer than recommended empiric antibiotic treatment of urinary tract infection in women: an avoidable waste of money.
      aug:
        au:
          Kahan NR
          Chinitz DP
          Kahan E
        affil: Leumit Health Fund, Tel Aviv, Israel
      sug:
        subj:
          Cystitis Drug Therapy
          Economics, Pharmaceutical
          Nitrofurans Therapeutic Use
          Ofloxacin Therapeutic Use
          Treatment Duration
          Urinary Tract Infections Drug Therapy
          Practice Guidelines
          Record Review
          Retrospective Design
          Human
      ab: CONTEXT: Current Israeli guidelines for the empiric treatment of uncomplicated urinary tract infection (UTI) in women recommend nitrofurantoin for 5 days. Some physicians nevertheless opt for ofloxacin, which should be prescribed for 3 days according to universally accepted guidelines. OBJECTIVE: To evaluate the economic consequences of longer than recommended durations of antibiotic therapy in the empiric treatment of uncomplicated UTI in women. DESIGN, SETTING AND PATIENTS: Data were derived from the electronic records of one of the four health maintenance organizations in Israel. The sample included all women aged 18-75 years who were diagnosed with acute cystitis or UTI from January 2001 to June 2002 and were empirically treated with antibiotics. Of the 7738 patients identified, 1138 received nitrofurantoin and 1054 ofloxacin. The excess expenditure accrued due to longer than recommended therapy with these drugs was evaluated. RESULTS: The rate of adherence was 22.23% for nitrofurantoin (95% CI=19.81%, 24.65%), and 4.08% for ofloxacin (95% CI=2.88%, 5.28%). The average excess expenditure per case was 5.78 USD (US Dollar) with ofloxacin and 3.43 USD with nitrofurantoin, resulting in an annual loss to the health maintenance organizations of approximately 19,000 USD. When extrapolated to the national population of 6.5 million, the loss due to inappropriate treatment of adult women is 190,000 USD. CONCLUSIONS: The lack of adherence to national and international guidelines with regard to the recommended duration of antibiotic treatment of UTI in women resulted in a significant and avoidable waste of health system resources. This study suggests that drug utilization analyses that concentrate solely on the choice of drug may be overlooking important information.
      pubtype: Academic Journal
      doctype:
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        tables/charts
        Journal Article
      ougenre: Article
    language: English
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