Therapeutic management of Urinary Tract Infections (UTI): A retrospective study in two Teaching Hospitals in Nigeria

Abstract

Urinary Tract Infection (UTI) is one of the most common diseases and a significant cause of morbidity in all age groups. There are large differences in the management of UTI with respect to definition, diagnosis and treatment. This retrospective study reviewed the diagnosis and drug treatment of UTI at the Teaching Hospitals of Ahmadu Bello University (ABUTH), Zaria and University of Maiduguri (UMTH). The results showed that majority of the infections
were due to Escherichia coli, followed by Klebsiella species and Staphylococcus aureus. The symptoms were dysuria, suprapubic pain, fever and/or chills, and lower abdominal discomfort, which differed in order of occurrence at the two institutions. The infecting organisms were sensitive to pefloxacin, ceftriazone and gentamicin while the most frequently used antibiotics were gentamicin, ciprofloxacin and ampicillin/cloxacillin in decreasing order at ABUTH. At UMTH,
ceftazidine, ofloxacin and gentamicin were frequently active against the infective organisms; and the most prescribed antibiotics were nitrofurantoin, ofloxacin, amoxicillin/clavulanic acid and co-trimoxazole in decreasing order. These results showed that institutional antibiotic policy in the treatment of urinary tract infections might have been based on the experience of the physician, cost of the drug and route of administration instead of prevalence and sensitivity patterns. It also showed that the guiding principle of the rational use of drugs is not strictly adhered to.