Comparative Efficacy of Empirical Vs Culture-Guided Antibiotic Therapy in Urinary Tract Infections in Adult Women
DOI:
https://doi.org/10.62497/irjm.116Abstract
Introduction: Urinary tract infections (UTIs) are among the most common bacterial infections in adult women. While empirical antibiotics are commonly prescribed, rising antimicrobial resistance challenges their effectiveness. This study compared the efficacy of empirical versus culture-guided antibiotic therapy in treating UTIs among adult women.
Methodology: A comparative observational study was conducted at Hayatabad Medical Complex, Peshawar, over 12 months from 13th March 2023 to 13th March 2024. A total of 115 adult female patients with symptomatic UTIs were enrolled and divided into two groups: one received empirical antibiotic therapy, while the other received culture-guided therapy based on urine culture and sensitivity reports. Outcomes were assessed on day 7 and after 30 days. Statistical analysis was done using SPSS version 25. Chi-square test, independent t-test, and binary logistic regression were applied, with p < 0.05 considered significant.
Results: The culture-guided group showed a higher treatment success rate (89.5%) compared to the empirical group (70.7%) (p = 0.015). Recurrence within 30 days was lower in the culture-guided group (5.3%) than in the empirical group (17.2%) (p = 0.034). In the empirical group, 42.3% of patients had received antibiotics ineffective against the isolated pathogens. E. coli was the most common organism (76.5%), showing high resistance to ampicillin and TMP-SMX, but good sensitivity to nitrofurantoin and fosfomycin.
Conclusion: Culture-guided therapy offers superior outcomes in UTI management compared to empirical treatment. Routine urine culture should be encouraged to guide effective antibiotic selection and reduce resistance.
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