{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T20:29:44Z","timestamp":1790627384227,"version":"4.1.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2016,11,11]],"date-time":"2016-11-11T00:00:00Z","timestamp":1478822400000},"content-version":"vor","delay-in-days":680,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Background. \u2003The updated 2010 Infectious Diseases Society of America guidelines recommended 3 first-line therapies for uncomplicated cystitis: nitrofurantoin, trimethoprim-sulfamethoxazole (TMP-SMX), and fosfomycin, while fluoroquinolones (FQs) remained as second-line agents. We assessed guideline concordance for antibiotic choice and treatment duration after introduction of the updated guidelines and studied patient characteristics associated with prescribing of specific antibiotics and with treatment duration.<\/jats:p>\n               <jats:p>Methods. \u2003We used the Epic Clarity database (electronic medical record system) to identify all female patients aged \u226518 years with uncomplicated cystitis in 2 private family medicine clinics in the period of 2011\u20132014. For each eligible visit, we extracted type of antibiotic prescribed, duration of treatment, and patient and visit characteristics.<\/jats:p>\n               <jats:p>Results. \u2003We included 1546 visits. Fluoroquinolones were the most common antibiotic class prescribed (51.6%), followed by nitrofurantoin (33.5%), TMP-SMX (12.0%), and other antibiotics (3.2%). A significant trend occurred toward increasing TMP-SMX and toward decreasing nitrofurantoin use. The duration of most prescriptions for TMP-SMX, nitrofurantoin, and FQs was longer than guidelines recommendations (longer durations were prescribed for these agents in 82%, 73%, and 71% of the prescriptions, respectively). No patient or visit characteristic was associated with use of specific antibiotics. Older age and presence of diabetes were independently associated with longer treatment duration.<\/jats:p>\n               <jats:p>Conclusions. \u2003We found low concordance with the updated guidelines for both the choice of drug and duration of therapy for uncomplicated cystitis in primary care. Identifying barriers to guideline adherence and designing interventions to decrease overuse of FQs may help preserve the antimicrobial efficacy of these important antimicrobials.<\/jats:p>","DOI":"10.1093\/ofid\/ofv159","type":"journal-article","created":{"date-parts":[[2015,10,27]],"date-time":"2015-10-27T00:54:47Z","timestamp":1445907287000},"source":"Crossref","is-referenced-by-count":63,"title":["Low Concordance With Guidelines for Treatment of Acute Cystitis in Primary Care"],"prefix":"10.1093","volume":"2","author":[{"given":"Larissa","family":"Grigoryan","sequence":"first","affiliation":[{"name":"Department of Family and Community Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Zoorob","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haijun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara W.","family":"Trautner","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Departments of Medicine and Surgery, Baylor College of Medicine"},{"name":"Houston VA Center for Innovations in Quality, Effectiveness and Safety, Michael E. 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