Physicians' adherence to guidelines for empirical treatment of urinary tract infection in Taiwan.

BACKGROUND AND PURPOSE Guidelines for prescribing antibiotics for uncomplicated urinary tract infection (UTI) were established in Taiwan in 2000. This study investigated the extent of physicians' adherence to the guidelines for treating ambulatory women with UTI. METHODS National Health Insurance claims data were used to evaluate antibiotic prescription behavior for UTI among physicians serving in hospitals across the range of accreditation levels in Taiwan, including medical centers, regional hospitals, district teaching/non-teaching hospitals and community clinics. A random sample of 5047 female ambulatory care visits during 2001 and 2003 was analyzed. RESULTS Sulfonamides (trimethoprim and trimethoprim-sulfamethoxazole), first-generation cephalosporins and quinolones were the most commonly prescribed drugs. The overall guideline adherence rate for physicians was 72.1%. The differences in guideline adherence rates for physicians in medical centers (86.6%), regional hospitals (81.3%), district teaching/non-teaching hospitals (76.9%) and community clinics (69.5%) were statistically significant (chi-squared test; p<0.0001). CONCLUSION Physicians in community clinics were less likely to adhere to guidelines in the treatment of ambulatory cases of UTI than physicians in any of the different levels of accredited hospitals in Taiwan.