A Study on The Antibiotic Use Pattern Among Patients with Urinary Tract Infections at a County Referral Hospital in Kenya

Abstract

Urinary tract infections are a prevalent cause of hospital visits, particularly among females and the elderly. Timely diagnosis and adherence to clinical guidelines are crucial for effective management. This study aimed to evaluate antibiotic usage patterns in urinary tract infection patients at Thika Level 5 Hospital, providing insights into prescribing practices and guideline adherence. A cross-sectional study enrolled 308 participants using purposive sampling. Data were extracted from patient files and supplemented with information on clinical guideline availability and supplies for UTI diagnosis and treatment. Descriptive analysis was conducted using Microsoft Excel, with strict adherence to ethical data protection protocols. The study found that a significant proportion of participants (n=78, 25.4%) fell within the 39-49 years age group. Patients under 49 years old constituted the majority (n=200, 65.1%). Cystitis (41.4%) was the most common specific urinary tract infection diagnosis, followed by pyelonephritis (23.5%) and urethritis (18.9%). Common comorbidities included diabetes mellitus (n=31, 27.0%), benign prostatic hyperplasia (BPH) (n=16, 13.9%), and hydrocele (n=11, 9.6%). Ceftriaxone was the predominant antibiotic prescribed in both outpatient (single STAT doses) and inpatient settings, followed by cefixime (n=105, 34.2%) and azithromycin (n=70, 22.8%). Notably, most prescribed antibiotics belonged to the World Health Organization Watch list. Among the 307 prescriptions reviewed, only 112 (36.7%) adhered to Kenyan Clinical Management and Referral Guidelines Volume III. Non-compliant prescriptions involved incorrect antibiotic choice, inappropriate duration and lack of indication. However, prescription frequency, route of drug administration and total dose generally aligned with recommendations.