[Rational use of medications in the treatment of urinary infections].

OBJECTIVES

MAIN: to encourage the rational use of medication in the treatment of uncomplicated acute cystitis (UAC). SECONDARY: to find the most common germs in our area and their sensitivity to medication, the most common anti-microbials used and patients age, and to evaluate the savings made through a policy of rational use of medication.Design. Retrospective, descriptive, observational study.

SETTING

La Solana Health Centre jointly with the biochemistry laboratory of the Talavera Area.

PARTICIPANTS

Probabilistic randomised sampling of clinical histories of women between 20 and 80 with episodes of UAC (349 in all) between 01/10/95 and 01/10/00.

MEASUREMENTS AND

RESULTS

First, the laboratory evaluated 591 urine cultures of complicated/uncomplicated UTI from 01/01/00 to 01/10/00, with study of the germs involved and their sensitivities. 373 positives were isolated: E. coli (78.3%), which had the greatest sensitivity to amoxycillin/clavulanic acid, fosfomycin, nitrofurantoin and cefixime; Proteus (7.2%) and Streptococcus D (5.8%). Second, clinical records were analysed for the following: antibiotics (norfloxacine and cyprofloxacine, the most common); length of treatment (average of 6.52.34 days); age of patient (greater number in under-65s).

CONCLUSIONS

E. coli is the most common germ in UTI and is highly sensitive to amoxy/clavulanic acid, nitrofurantoin, fosfomycin and cefixime. Resistance to cyprofloxacine and norfloxacine are starting to be significant. In UAC the three-day model should be encouraged for young women; and 7 days is recommended for the over-65s. More rational use of medication would increase efficacy and suppose a considerable economic saving in our area.