Improper Antibiotic Treatment for Bladder Infections

In a recent study of more than 13,000 women going to a doctor because of a bladder infection, more than 95% of whom had an acute bladder infection (not a recurrent one), only 37% were prescribed the preferred treatment for this condition: the combination antibiotic trimethoprim/sulfamethoxazole (sometimes prescribed by the brand names of Bactrim, Septra, or Cotrim). Almost as many (32%) were prescribed one of the heavily-promoted fluoroquinolone antibiotics such as ciprofloxacin (CIPRO) which are not the first-choice drug for acute bladder infections. When such drugs are used even though there is a better alternative, this contributes to the rapidly increasing and health-threatening problem of resistance to antibiotics, whereby when the fluoroquinolones are actually needed, people are resistant to them (see related article). The recommended duration of treatment for an acute bladder infection is three days of the antibiotic, and yet, less than 10% of the prescriptions were for three days. The most common duration of treatment was 10 days, followed by seven and five days. Thus, in addition to using the wrong antibiotic most of the time, the duration of therapy was too long most of the time, further contributing to the problem of antibiotic resistance.

When the authors examine the medical specialties of the doctors who prescribed these drugs, they found that obstetricians/gynecologists and urologists were only half as likely to prescribe the preferred treatment, trimethoprim/sulfamethoxazole, as were specialists in internal medicine or family practice.