Abstract
Context: Trimethoprim-sulfamethoxazole (TMP-SMX) and nitrofurantoin were until recently the two drugs recommended in clinical guidelines in Israel for empiric treatment of uncomplicated urinary tract infection (UTI) in women. Objectives: The objective of this study is to evaluate the economic impact of physician non-adherence to these recommendations. Design setting and patients: Data were derived from the electronic patient records of the Leumit Health Fund. Cases of women aged 18 to 75 with a diagnosis of acute cystitis or UTI that were empirically treated with antibiotics from January 2001 to June 2002 were identified. The final sample comprised 7738 physician-patient encounters. The proportion of cases treated with each individual drug was calculated, and the excess expenditure because of non-adherence to guidelines from the perspective of the Health Maintenance Organization (HMO) was evaluated using 5 days of therapy with nitrofurantoin as the reference treatment. Results: TMP-SMX was the most frequently prescribed drug (25-81%), followed by nitrofurantoin (14-71%) representing a 40-52% rate of adherence to the guidelines. Drugs from the fluoroquinolone family were prescribed in 22-82% of cases. Cost of treatment in approximately 70% of the cases exceeded the expected cost of the guideline therapy. Conclusions: Suboptimal adherence to the guidelines resulted in a significant and avoidable waste of the health plan's resources in both drugs and money.
Original language | English |
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Pages (from-to) | 437-441 |
Number of pages | 5 |
Journal | Journal of Clinical Pharmacy and Therapeutics |
Volume | 29 |
Issue number | 5 |
DOIs | |
State | Published - Oct 2004 |
Keywords
- Drug utilization
- Electronic patient records
- Empiric antibiotic treatment
- Guidelines
- Pharmacoeconomics
- Uncomplicated urinary tract infection