# Antibiotic resistance in urinary tract infections: A study on trends and contributing factors in outpatient care among Indian patients

## TL;DR

This study examines rising antibiotic resistance in urinary tract infections among Indian outpatients and identifies factors like inappropriate antibiotic use and comorbidities.

## Contribution

The study provides insights into resistance trends and contributing factors in outpatient UTIs in India.

## Key findings

- E. coli was the most common UTI pathogen, showing significant resistance to trimethoprim-sulfamethoxazole and fluoroquinolones.
- Inappropriate antibiotic use and comorbidities like diabetes were strongly associated with higher resistance rates.
- ESBL-producing E. coli strains accounted for 8% of isolates, highlighting growing resistance trends.

## Abstract

UTIs are quite a common infection in outpatient care; however, the rise of antimicrobial resistance raises considerable challenge.
This study determines the trend of resistance among UTI pathogens and considers factors contributing to it, such as prescribing, which
often occurs in an outpatient setting. It was a single-setting retrospective analysis of 80 outpatient UTI cases. This involved
bacterial isolation, antimicrobial susceptibility testing and analysis of potential factors that may have led to resistance, such as
antibiotic prescribing and patient comorbidities. Descriptive statistics were therefore applied in SPSS for data analysis. The most
common pathogen was Escherichia coli (70%) and exhibited significant resistance to trimethoprim-sulfamethoxazole at 30% and to
fluoroquinolones at 22%. Extended-spectrum β-lactamase (ESBL)-producing strains comprised 8% of E. coli isolates.
Higher resistance rates were associated with inappropriate antibiotic use (p = 0.001), frequent use of antibiotics (p = 0.004) and
comorbid conditions such as diabetes (p = 0.002). The levels of resistance to antimicrobials in outpatient UTIs are rising, especially
due to the inappropriate prescribing and health conditions. Improvement of stewardship of antibiotics and accuracy of diagnosis are
required in controlling trends in resistance seen in outpatient care.