Print E-mail
Volume 40, Number 6, December 2007

Physicians’ adherence to guidelines for empirical treatment of urinary tract infection in Taiwan


I-Shiow Jan, Shou-Hsia Cheng, Hui-Chun Hsu, Po-Ren Hsueh
Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei; 2Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei; and 3Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan

Received: December 1, 2005    Revised: January 13, 2006    Accepted: August 9, 2006   

 

Corresponding author:

Dr. Po-Ren Hsueh, Departments of Laboratory Medicine and Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei 100, Taiwan. E-mail: Dr. Po-Ren Hsueh This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

 



 

Background and purpose: 

Guidelines for prescribing antibiotics for uncomplicated urinary tract infection (UTI) were established in Taiwan in 2000. This study investigated the extent of physicians’ adherence to the guidelines for treating ambulatory women with UTI.

 



 

Methods:

National Health Insurance claims data were used to evaluate antibiotic prescription behavior for UTI among physicians serving in hospitals across the range of accreditation levels in Taiwan, including medical centers, regional hospitals, district teaching/non-teaching hospitals and community clinics. A random sample of 5047 female ambulatory care visits during 2001 and 2003 was analyzed.

 



 

Results:

Sulfonamides (trimethoprim and trimethoprim-sulfamethoxazole), first-generation cephalosporins and quinolones were the most commonly prescribed drugs. The overall guideline adherence rate for physicians was 72.1%. The differences in guideline adherence rates for physicians in medical centers (86.6%), regional hospitals (81.3%), district teaching/non-teaching hospitals (76.9%) and community clinics (69.5%) were statistically significant (chi-squared test; p<0.0001).

 



 

Conclusion:

Physicians in community clinics were less likely to adhere to guidelines in the treatment of ambulatory cases of UTI than physicians in any of the different levels of accredited hospitals in Taiwan.

 



 

Key words:

Drug utilization review; Guideline adherence; Practice guidelines; Urinary tract infections


 



 

J Microbiol Immunol Infect. 2007;40:532-536.