Antibiotic treatment of acute uncomplicated cystitis based on rapid urine test and local epidemiology: lessons from a primary care series

Table 4 Evaluation of different treatment strategies based on local epidemiology and on the results of rapid urine test (RUT) in a cohort of 346 patients with symptoms of acute uncomplicated cystitis

	Antibiotic (ATB) Treatment strategy
	ATB for all symptomatic patients (i.e.no RUT used)	ATB only in patients with positive RUT^a
Patients treated (%)	347 (100)	311 (89)
Appropriate ATB decision ^b (%)	253 (73)	278 (80)	0.02^d
No ATB, negative UC^c	0	31
ATB, positive UC	253	247
Inappropriate ATB decision (%)	94 (27%)	70 (20%)
ATB, negative UC	94	64
No ATB, positive UC	0	6
Overall susceptibility rates according to the ATB regimen ^e (%)
Fosfomycin	89	90
Nitrofurantoin	98	98
TMP-SMX	85	86
Ofloxacin	94	95
Pivmecillinam	76	78
Fosfomycin, except if RUT-
For nitrites and age < 30: nitrofurantoin		93
Fosfomycin, except if RUT-
For nitrites and age < 30: ofloxacin		93

^aRUT considered positive when leukocytes and/or nitrites were detected.
^bATB decision considered appropriate or not according to the results of urine analysis.
^cUC: urine culture.
^dNB: p = 0.02 when appropriate and inappropriate ATB decision were compared using standard thresholds, and p = 0.03 using reduced thresholds.
^eSusceptibility rate for patients with a positive urine culture.

ISSN: 1471-2334