School of Pharmacy, University of the Western Cape, Cape Town, South Africa.
S Afr Med J. 2022 Jul 1;112(7):487-493.
Antibiotic resistance is a global healthcare burden complicating the management of infections. Urinary tract infections (UTIs) are commonly treated in primary care. Managing UTIs appropriately in primary care can combat antibiotic resistance. The treatment practices for UTIs in primary care in Western Cape Province, South Africa, are not well described.
To describe treatment of UTIs in adults in primary care in the Cape Town metropole public sector of the Western Cape.
A retrospective multicentre medical records review of patients diagnosed with UTIs was conducted during 1 October 2020 - 28 February 2021. Six public sector primary healthcare facilities were included in the study through random selection from three of the four substructures in the Cape Town metropole. Medical records of adult patients diagnosed with UTIs, through clinical diagnosis or microbiological testing, were identified via a selective sampling process. Data were collected from medical records using a standardised data collection tool.
A total of 401 UTI episodes occurred in 383 patients during the study period. The majority of UTI episodes (84.3%) occurred in females, complicated UTIs (74.1%) were more common than uncomplicated UTIs, and nitrofurantoin (57.1%) was frequently prescribed, followed by ciprofloxacin (39.7%). Compliance with urine microscopy recommendations was low (6.7%), and antibiotics were appropriately selected in 75.0% of uncomplicated and 70.0% of complicated UTI episodes.
Interventions are required to improve compliance with treatment recommendations as per the standard treatment guidelines, especially when selecting the appropriate antibiotic, duration of therapy and urine microscopy.
抗生素耐药性是全球医疗保健的负担，使感染的管理复杂化。尿路感染（UTI）在初级保健中经常治疗。在初级保健中适当治疗 UTI 可以对抗抗生素耐药性。南非西开普省的初级保健中治疗 UTI 的做法尚不清楚。
描述西开普省开普敦大都市公立部门初级保健中成人 UTI 的治疗情况。
在 2020 年 10 月 1 日至 2021 年 2 月 28 日期间，对在 6 家公共部门初级保健机构中诊断为 UTI 的患者进行了回顾性多中心病历回顾。通过从开普敦大都市的四个亚结构中的三个中随机选择，将该研究纳入了该研究。通过临床诊断或微生物检测，从病历中确定了患有 UTI 的成年患者的病历。通过有针对性的抽样过程，使用标准数据收集工具从病历中收集数据。
在研究期间，共发生了 383 名患者的 401 例 UTI 发作。大多数 UTI 发作（84.3%）发生在女性中，复杂 UTI（74.1%）比单纯 UTI 更常见，并且经常开处方的药物是呋喃妥因（57.1%），其次是环丙沙星（39.7%）。遵守尿液显微镜检查建议的比例较低（6.7%），在单纯性 UTI 发作的 75.0%和复杂性 UTI 发作的 70.0%中，抗生素的选择是适当的。
需要采取干预措施，以提高对标准治疗指南的治疗建议的遵守率，特别是在选择适当的抗生素、治疗持续时间和尿液显微镜检查时。
