Evaluation of antibiotic prescribing patterns and post- treatment follow-up in patients with urinary tract infections: A Comprehensive analysis of clinical practices and outcomes

Abstract

Introduction: Urinary tract infections (UTIs) are a leading cause of Emergency Department (ED) visits and hospitalizations worldwide, with the Middle East showing a rising incidence. However, limited data exists on the prevalence and antibiotic prescribing patterns for UTIs in this region. Women, particularly in the 16–35 years age group, are at an increased risk of UTI. The study explores empiric antibiotic therapy for UTIs based on national recommendations, the recurrence rates, and factors influencing relapse and reinfection. Objective: This study aims to evaluate empiric antibiotic prescribing patterns for UTIs in a tertiary hospital, assess the outcomes of treatment, and analyze factors related to relapse and recurrence of UTIs. Methodology: A retrospective review of medical records was conducted for patients aged 18 years or older diagnosed with a UTI at a tertiary care hospital in the Northern Emirates, UAE. Data were collected from the Internal Medicine, Urology, and Obstetrics & Gynecology departments between January 2022 and December 2023. A structured data collection form captured demographic, clinical, microbiological, and pharmacotherapeutic details. Antibiotic treatments and patient outcomes were analyzed using SPSS software, with chi-square tests and multiple regression analyses conducted to assess risk factors for relapse and recurrence. Results: Out of 273 reviewed records, 198 patients were included, with 59.6% being female. The most common bacterial pathogen identified was Escherichia coli (33.3%). Carbapenems were the most prescribed antibiotics, used in 56% of cases, followed by ceftriaxone (14.8%). The average treatment duration was 8.5 days, with 25.3% achieving a complete cure during hospitalization. Complications such as febrile UTI were noted in 37.9% of patients, with 11.6% experiencing prolonged symptoms. Factors significantly associated with relapse included a history of anatomical defects (p = 0.006). Regression analysis showed that the type and duration of antibiotics significantly affected UTI recurrence (p < 0.001). Conclusion: The study highlights the pattern of antibiotic use in the treatment of UTIs. The recurrence of UTIs was significantly influenced by anatomical defects, underscoring the need for targeted therapeutic strategies. A tailored approach to antibiotic therapy, aligned with local resistance patterns, is essential for optimizing treatment outcomes and preventing recurrent infections.