Overuse of antibiotics for urinary tract infections in pregnant refugees, Lebanon.
Publication year
2024Source
Bulletin of the World Health Organization, 102, 6, (2024), pp. 389-399ISSN
Publication type
Article / Letter to editor
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Organization
Medical Microbiology
Journal title
Bulletin of the World Health Organization
Volume
vol. 102
Issue
iss. 6
Page start
p. 389
Page end
p. 399
Subject
Medical Microbiology - Radboud University Medical CenterAbstract
OBJECTIVE: To determine whether adding urine culture to urinary tract infection diagnosis in pregnant women from refugee camps in Lebanon reduced unnecessary antibiotic use. METHODS: We conducted a prospective, cross-sectional study between April and June 2022 involving pregnant women attending a Médecins Sans Frontières sexual reproductive health clinic in south Beirut. Women with two positive urine dipstick tests (i.e. a suspected urinary tract infection) provided urine samples for culture. Bacterial identification and antimicrobial sensitivity testing were conducted following European Committee on Antimicrobial Susceptibility Testing guidelines. We compared the characteristics of women with positive and negative urine culture findings and we calculated the proportion of antibiotics overprescribed or inappropriately used. We also estimated the cost of adding urine culture to the diagnostic algorithm. FINDINGS: The study included 449 pregnant women with suspected urinary tract infections: 18.0% (81/449) had positive urine culture findings. If antibiotics were administered following urine dipstick results alone, 368 women would have received antibiotics unnecessarily: an overprescription rate of 82% (368/449). If administration was based on urine culture findings plus urinary tract infection symptoms, 144 of 368 women with negative urine culture findings would have received antibiotics unnecessarily: an overprescription rate of 39.1% (144/368). The additional cost of urine culture was 0.48 euros per woman. CONCLUSION: A high proportion of pregnant women with suspected urinary tract infections from refugee camps unnecessarily received antibiotics. Including urine culture in diagnosis, which is affordable in Lebanon, would greatly reduce antibiotic overprescription. Similar approaches could be adopted in other regions where microbiology laboratories are accessible.
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- Academic publications [245263]
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- Faculty of Medical Sciences [93208]
- Open Access publications [106159]
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