The Impact of Empirical Management of Acute Cystitis on Unnecessary Antibiotic Use

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Abstract
URINARY TRACT infections (UTIs) account for 0.9% to 2.1%1,2 of an estimated 700 million office visits each year in the United States.3 An antibiotic is prescribed in 58% of encounters, representing 5% of all antibiotic prescriptions to adults.4 In recent years, antibiotic resistance among common uropathogens has been increasing.5 At the same time, physicians have been advised that empirical antibiotic treatment without culture is appropriate in cases of uncomplicated UTI.6-8 The majority of these occur in women; however, up to half of women with symptoms suggestive of UTI do not demonstrate significant bacteriuria on culture.9-12 As a result, empirical treatment may promote unnecessary antibiotic use, which has been associated with increased levels of antimicrobial resistance.13-17