Intended for healthcare professionals


Improving antibiotic prescribing for uncomplicated UTIs

BMJ 2023; 383 doi: (Published 02 November 2023) Cite this as: BMJ 2023;383:p2456

Linked research

Effects of a multimodal intervention in primary care to reduce second line antibiotic prescriptions for urinary tract infections in women

  1. Morten Lindbæk, professor, 1,
  2. Arnfinn Sundsfjord, professor23
  1. 1Antibiotic centre for primary care, Department of general practice, University of Oslo, Oslo, Norway
  2. 2Norwegian National Advisory Unit on Detection of Antimicrobial Resistance, Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway
  3. 3Host-Microbe-Interaction research group, Department of Medical Biology, UiT The Artic University of Norway, Tromsø, Norway
  1. Correspondence to: M Lindbæk morten.lindbak{at}

Prescribing patterns in primary care are key drivers of antimicrobial resistance

Urinary tract infection (UTI) is a frequent reason for consulting in primary care and is the leading reason for an antibiotic prescription among women.1 Community acquired UTIs are caused predominantly by uropathogenic Escherichia coli, a pathogen with an increasing prevalence of antimicrobial resistance.2 Multiple studies have shown a direct association between antibiotic use and the selection and spread of antimicrobial resistance at the population level,3 including total antibiotic prescribing and proportion of broad spectrum antibiotics prescribed.4,5 Most antibiotics (80-90%) are prescribed outside of hospitals in high income countries. The pattern of antibiotic prescribing in primary care is therefore an important and modifiable driver of antimicrobial resistance. Quinolones have been used extensively for treating uncomplicated UTIs in some countries. This group of antibiotics is a key driver of resistance and associated with substantial adverse effects on nerves, muscles, and tendons.6

In a linked The BMJ paper (doi:10.1136/bmj-2023-076305), Schmiemann and colleagues report a large, …

View Full Text

Log in

Log in through your institution


* For online subscription