Antimicrobial Prescription Practices for Outpatients with Cystitis: A Multicenter, Medical Record-Based Study

Abstract To promote antimicrobial stewardship (AMS) and appropriate antibiotic use, we studied antimicrobial prescription rates for uncomplicated cystitis, a common outpatient disease requiring antibiotic treatment in Japan. This multicenter retrospective study was performed from January 1, 2018, to December 31, 2020, targeting outpatients aged ≥20 years whose medical records revealed International Classification of Diseases (ICD-10) codes suggesting uncomplicated cystitis (N300). We divided eligible cases into two age groups (20–49 years and ≥50 years) and defined broad-spectrum antimicrobials as fluoroquinolones, third-generation cephalosporins, and faropenem. Primary and secondary outcomes were defined as the prescription rates of broad-spectrum antimicrobials for the disease and the association of antimicrobial types with recurrence. The data of 1,445 patients were collected and that of 902 patients were analyzed. The overall proportion of broad-spectrum antimicrobial prescriptions was 69.1%. The broad-spectrum agents were prescribed frequently in the older group, male patients, and internal medicine. Recurrence was observed in 37 (4.1%) cases, and age, sex, or antimicrobial types were not associated with the recurrence. Hence, approximately two-thirds of antimicrobials prescribed for uncomplicated cystitis were broad-spectrum agents. Administration of broad-spectrum antimicrobials was not associated with the prevention of the recurrence of cystitis.