Antibiotic Treatment of Urinary Tract Infections (UTIs) In Primary Care: An Italian Pilot Study

Background: Urinary tract infections (UTIs) are extremely common. In the global scenario, due to the rise of antibiotic resistance worldwide, they present a substantial public health challenge. The aim of this cross-sectional study was to review antibiotic utilization in the management of UTIs in primary care practices in Italy. Materials and methods: Patients in Italian primary care settings with a confirmed diagnosis of UTI and receiving antibiotic therapy were enrolled in a cloud-based pharmacovigilance study. Results: The study included 5232 patients (3903 females, 1329 males) who had been prescribed antibiotics for UTI between July 2014 and December 2015. Quinolones were prescribed for 4889 patients (94%) as the first line treatment. In the 14-days follow-up period, 3181 patients (60%) received at least one different antibiotic medication. Fifty-eight percent (n=1844) of patients further received antibiotics on day 2 and day 3 of the follow-up period. Different quinolones and cephalosporins were the most prescribed medications in this sub-population. Conclusion: The study raises concerns about antibiotic and specifically quinolone overuse in Italian UTI outpatients. Policy-making bodies and professional societies should prioritize reducing the inappropriate use of antibiotics. This can be achieved through antimicrobial stewardship programs, which are one of the primary solutions to address the growing problem of antimicrobial drugs resistance