Antibiotic resistance in urinary tract infections: A study on trends and contributing factors in outpatient care among Indian patients.
UTIs are quite a common infection in outpatient care; however, the rise of antimicrobial resistance raises considerable challenge. This study determines the trend of resistance among UTI pathogens and considers factors contributing to it, such as prescribing, which often occurs in an outpatient setting. It was a single-setting retrospective analysis of 80 outpatient UTI cases. This involved bacterial isolation, antimicrobial susceptibility testing and analysis of potential factors that may have led to resistance, such as antibiotic prescribing and patient comorbidities. Descriptive statistics were therefore applied in SPSS for data analysis. The most common pathogen was Escherichia coli (70%) and exhibited significant resistance to trimethoprim-sulfamethoxazole at 30% and to fluoroquinolones at 22%. Extended-spectrum β-lactamase (ESBL)-producing strains comprised 8% of E. coli isolates. Higher resistance rates were associated with inappropriate antibiotic use (p = 0.001), frequent use of antibiotics (p = 0.004) and comorbid conditions such as diabetes (p = 0.002). The levels of resistance to antimicrobials in outpatient UTIs are rising, especially due to the inappropriate prescribing and health conditions. Improvement of stewardship of antibiotics and accuracy of diagnosis are required in controlling trends in resistance seen in outpatient care.