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Urinary tract infections (UTIs) are among the most common reasons for outpatient antibiotic prescriptions. At Denver Community Health Services, which manages >400,000 outpatient visits each year, levofloxacin was substituted as the preferred antibiotic for outpatient UTI therapy in 1999, when the trimethoprim-sulfamethoxazole (TMP-SMX) resistance rate reached 24%. Subsequently, a rise in the levofloxacin resistance rate was observed.
The investigators used institutional pharmacy and microbiology laboratory databases to assess the changes in outpatient antibiotic use and resistance between 1998 and 2005. During the study period, levofloxacin prescriptions per 1000 outpatient visits increased from 3.1 to 12.7 (P<0.01). Meanwhile, the percentag…