Methods: This study is a retrospective chart review that examined all patients with AUC at Kaiser Permanente Fontana Medical Center who were prescribed ciprofloxacin. Included patients: non-pregnant females between the ages of 18 and 65. Excluded patients: male patients, pregnant women, females > 65 years old, and patients with pyelonephritis, renal stones, ESRD on hemodialysis, or anatomical abnormalities. Data were analyzed using descriptive statistics with 95% confidence intervals.
Results: 494 patient charts met criteria to be included in the study. Review of charts showed that ciprofloxacin was inappropriate, 464/494 charts (94%) of the time (95% CI - 455 to 472). The reasons that it was inappropriate were: 297/494 (60%): no previous urine culture showing resistance to other antibiotics (95% CI - 288 to 305); 418/494 (85%): inappropriate ciprofloxacin dosage (95% CI - 409 to 426); 49/494 (10%): h/o UTI with resistance to ciprofloxacin (95% CI - 40 to 57). Furthermore, 85% of the time (95% CI - 410 to 427), the duration of ciprofloxacin was incorrect; the range of days prescribed was 7 to 10 days.
Conclusion: Chart review revealed more than 90% incidence of inappropriate ciprofloxacin prescription (incorrect therapy, too high dosage, too extended duration). This result underscores the critical importance of developing sustained provider interventions and outpatient antibiotic stewardship programs to improve patient care and cost savings.
R. Guo, None
P. Cho, None
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