[Using antibiotics in urinary tract infection in a first level of attention health care unit in Bogota, Colombia]

Author(s): Murillo-Rojas OA, Leal-Castro AL, Eslava-Schmalbach JH

Affiliation(s): Universidad Nacional de Colombia-UNISALUD. oamurillor@unal.edu.co

Publication date & source: 2006-05, Rev Salud Publica (Bogota)., 8(2):170-81.

Publication type: Comparative Study; English Abstract

OBJECTIVES: Describing using antibiotics for urinary tract infection in a first level of attention health care unit. METHODS: This was an observational and descriptive study of a cohort of register-based patients attending the Universidad Nacional de Colombia's Health Service Unit (UNISALUD) diagnosed as suffering urinary tract infection between July 2002 and June 2003. RESULTS: 6,3 % urinary tract infection incidence was found, especially affecting women (84,4 %). The signs and symptoms were the same as those usually found in this disease. 58% corresponded to lower tract infection, 36 % to non-specific infection, 4 % to infection during pregnancy and 2 % to upper tract infection. The following uropathogens were isolated: E. coli (88.9%), Proteus spp. (5,1%), Klebsiella spp. (3,7 %), Enterobacter spp. (1%), Citrobacter spp. (1 %) and Staphylococcus saprophyticus (0,3 %). There was great variability in the antibiotic schemes being prescribed. Nitrofurantoin, Trimethoprim-sulfamethoxizole and Fluoroquinolones were the most prescribed, per defined daily dose; these antibiotics presented low susceptibility for the uropathogens so isolated. There was a 4:1 ratio of empirical treatment respecting confirmed ones. 98 % of the cases corresponded to patients suffering from a single event or having just 1 to 2 recurrences. DISCUSSION The urinary tract infection studied here presented a similar epidemiological profile to that usually found in the general population. The isolated microorganism's low susceptibility to the prescribed antibiotics could reflect inappropriate use of antibiotics by the health service, inducing selective pressure on bacterial resistance.