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Drugs (and drug costs) for urinary tract infections vary among specialties

A study also raised questions about whether current practices are increasing antibiotic resistance.

By Andis Robeznieks, amednews staff. Feb. 4, 2002.

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The type of physician a woman sees to treat her urinary tract infection could make a difference of up to $69 for the cost of a 10-course drug treatment.

According to researchers in Illinois and California, "subspecialty cultures" may determine whether it costs $1.79, $20.34 or $70.98 (in 1999 prices) for a prescription received from a general practitioner, obstetrician-gynecologist or an internist.

In addition, Elbert S. Huang, MD, MPH, at the University of Chicago and Randall S. Stafford, MD, PhD, at Stanford University, Stanford, Calif., concluded that the drugs doctors prescribe for common infections also can affect patients' well-being and the growth of antibiotic resistance.

Their report, published Jan. 14 in the Archives of Internal Medicine, studied outcomes of 1,478 visits made by women between 18 and 75 years old from 1989 through 1998.

Despite recommendations published in 1993 and 1999 urging doctors to prescribe trimethoprim-sulfamethoxazole for treating UTIs, prescriptions for that antibiotic declined significantly during the period studied.

"We observed prescribing patterns that run counter to the recommendations of the Infectious Disease Society of America," stated Drs. Huang and Stafford in their report. "We are very concerned that antibiotic prescribing will diverge even further from formal recommendations as physicians begin to use new broad-spectrum fluoroquinolones, despite their overly broad coverage and increased costs."

In 1989-90, doctors prescribed trimethoprim-sulfamethoxazole about 48% of the time, the report stated. In 1997-98, however, this figure fell to 24%. At the same time, Drs. Huang and Stafford said fluoroquinolones increased from 19% of UTI prescriptions to 29%. Also, nitrofurantoin prescriptions jumped from 14% to 30%. [...]