Increased Fluoroquinolone Use for Outpatient UTIs

Urinary tract infection (UTI) is one of the most common indications for outpatient antibiotic therapy. Current guidelines recommend trimethoprim-sulfamethoxazole (TMP-SMX) as first-line treatment unless local rates of resistance among urinary Escherichia coli isolates exceed 15% to 20%. Are TMP-SMX resistance rates prompting inappropriate use of fluoroquinolones (FQs)? Using data for 2000–2002 from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey, researchers examined antimicrobial-use patterns for outpatient UTIs in U.S. women.

Of the 1914 UTI visits examined, 75% took place in physician offices, 18% in emergency departments, and 8% in hospital clinics. FQs were the most commonly prescribe…