EVALUATION OF ANTIMICROBIAL TREATMENT PRACTICES FOR URINARY TRACT INFECTIONS IN PREGNANT WOMEN IN TERTIARY CARE CLINICAL SETTINGS OF PAKISTAN

Urinary tract infections (UTIs) are the most common infections of pregnancy and pose great therapeutic challenges. The objective of the present study was to evaluate and compare the antimicrobial treatment practices for UTIs during pregnancy in comparison with the standard treatment guidelines. A prospective cross sectional study was conducted on 782 pregnant female patients suffering from UTIs in hospitals of Wah Cantt, District Rawalpindi, Pakistan. Prescriptions and available laboratory test reports including complete blood count (CBC) from each patient was taken. Statistical tests One Way ANOVA and chi-square tests (P≤0.05) were performed to obtain the desired outcomes. It was evaluated that none of the clinical setting have developed its own antibiogram or local antibiotic use guidelines. Standard management guidelines for antimicrobial therapy for UTI in pregnancy were followed in only 16.7% patients. Moreover only two drugs from the standard management guidelines were prescribed to the patients. It was determined that statistically significant population (p<0.05) were being prescribed with the drugs not recommended by any guidelines. 26.9% patients were being prescribed category “C” drug. One of reasons for not prescribing the 1^st line drug is its shortage in Pakistan regardless of being part of essential drug list of Pakistan. Appropriateness of antibiotic prescribing is also affected by using pregnancy category “C” drugs (p<0.05). It is recommended that safe prescribing practices should be adopted and patients should be monitored closely for desired clinical outcomes. The Drug Regulatory Authority of Pakistan (DRAP) should ensure the availability of essential medicines in country.