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Objectives: To characterize the pattern of indication of antibiotic regimens for CA-UTI; to evaluate the adequacy of antibiotic empirical therapy in CA-UTI and the resistance profile of the bacterial isolates. Methods: An observational study was conducted, where the prevalence and resistance profiles of the microorganisms involved and the pattern of antibiotic indication were investigated through a cross-sectional approach. Patients presenting with UTI symptomatology and antibiotic indication were recruited through pharmacies in the Lisbon area. Upon inclusion, participants collected a urine sample and responded to a questionnaire characterizing the indication pattern and symptomatology presented. Samples were referred to a microbiology laboratory for urinalysis and antimicrobial susceptibility tests were performed according to EUCAST. Data were analyzed using IBM SPSS v20.0. Results: A sample of 33 patients was obtained. Given the indicated therapy, 55.2% (n=6) corresponded to first line therapy and 10.3% to fluoroquinolones. It was also found that 6 (22.2%) patients were treated with antibiotics and had no confirmed UTI. The most isolated microorganism was E. coli (84.2%), followed by P. mirabilis (5.3%), P. aeruginosa (5.3%) and Klebsiella sp. (5.3%). Finally, a low resistance to first-line therapy and quinolones was observed, whilst high resistance was found to amoxicillin clavulanate (n=10; 52.6%). Conclusion: This study revealed that most patients with UTI used nitrofurantoin and fosfomycin empirically (both included in first line therapy), and only a small number used quinolones. As expected, the most commonly isolated microorganism was E. coli. A worrisome finding was that nearly a quarter of patients were prescribed antibiotics without indication.

Evaluation of Empirical Antibiotic Therapy for the Treatment of Community-Acquired Urinary Tract Infections (CA-UTI)