{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T18:27:13Z","timestamp":1790792833325,"version":"4.1.0"},"reference-count":46,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,7,20]],"date-time":"2022-07-20T00:00:00Z","timestamp":1658275200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Urinary tract infections, especially cystitis, are common infections; they are the second most prevalent cause of antibiotic prescriptions in community pharmacies. To reduce antimicrobial resistance, guidelines are revised regularly. This study aims to assess compliance between prescriptions collected in community pharmacies and French cystitis guidelines. A treatment is considered compliant if the nature, dosage, and duration of the antibiotics are correct. Only women aged 18\u201365 years with a diagnosis of cystitis were eligible. The participation of 16 pharmacies resulted in 303 prescriptions. Most infections were classified as uncomplicated cystitis (79.2%), general practitioners were the prescribers in more than 9 out of 10 cases, and fosfomycin trometamol was the antibiotic dispensed for 1 in 2 women. An average compliance of 66% was observed, but with disparities according to the type of cystitis. Two-thirds of cases of uncomplicated cystitis and recurrent cystitis followed the recommendations, whereas only 15% of cystitis cases that were at risk of complication did so. The inclusion of a urine examination in uncomplicated cystitis decreased the overall compliance rate to 5.8%. These results show the essential role played by pharmacists; they are the last line of defence before dispensing antibiotics. They must know the recommendations in order to apply them.<\/jats:p>","DOI":"10.3390\/antibiotics11070976","type":"journal-article","created":{"date-parts":[[2022,7,20]],"date-time":"2022-07-20T11:22:24Z","timestamp":1658316144000},"page":"976","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Assessment of the Compliance of Cystitis Management According to French Recommendations through the Analysis of Prescriptions Collected in Community Pharmacies"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6348-4717","authenticated-orcid":false,"given":"Arthur","family":"Piraux","sequence":"first","affiliation":[{"name":"University of Angers, Inserm, CNRS, MINT, SFR ICAT, F-49000 Angers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramy","family":"Hammoud","sequence":"additional","affiliation":[{"name":"Methodology and Biostatistics Department, University of Angers, F-49000 Angers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7056-9257","authenticated-orcid":false,"given":"J\u00e9r\u00e9mie","family":"Riou","sequence":"additional","affiliation":[{"name":"University of Angers, Inserm, CHU Angers, CNRS, MINT, SFR ICAT, F-49000 Angers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souhil","family":"Lebdai","sequence":"additional","affiliation":[{"name":"Department of Urology, Angers University Hospital, F-49000 Angers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7524-8295","authenticated-orcid":false,"given":"S\u00e9bastien","family":"Faure","sequence":"additional","affiliation":[{"name":"University of Angers, Inserm, CNRS, MINT, SFR ICAT, F-49000 Angers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1016\/S0399-077X(05)80355-5","article-title":"Soci\u00e9t\u00e9 de pathologie infectieuse de langue fran\u00e7aise Deuxi\u00e8me conf\u00e9rence de consensus en th\u00e9rapeutique anti-infectieuse","volume":"20","author":"Porter","year":"1990","journal-title":"M\u00e9d. Mal. Infect."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1086\/318850","article-title":"Urinary Tract Infections: Disease Panorama and Challenges","volume":"183","author":"Stamm","year":"2001","journal-title":"J. Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1128\/microbiolspec.UTI-0002-2012","article-title":"Clinical Presentations and Epidemiology of Urinary Tract Infections","volume":"4","author":"Geerlings","year":"2016","journal-title":"Microbiol. Spectr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/S0002-9343(02)01054-9","article-title":"Epidemiology of urinary tract infections: Incidence, morbidity, and economic costs","volume":"113","author":"Foxman","year":"2002","journal-title":"Am. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1016\/j.molmed.2016.09.003","article-title":"Urinary Tract Infection: Pathogenesis and Outlook","volume":"22","author":"McLellan","year":"2016","journal-title":"Trends Mol. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e103","DOI":"10.1093\/cid\/ciq257","article-title":"International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases","volume":"52","author":"Gupta","year":"2011","journal-title":"Clin. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.ijantimicag.2011.09.009","article-title":"Critical review of current definitions of urinary tract infections and proposal of an EAU\/ESIU classification system","volume":"38","author":"Johansen","year":"2011","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1038\/nrmicro3432","article-title":"Urinary tract infections: Epidemiology, mechanisms of infection and treatment options","volume":"13","author":"Walker","year":"2015","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_9","unstructured":"Haute autorit\u00e9 de Sant\u00e9 (2021). Cystite Aigu\u00eb Simple, \u00e0 Risque de Complication ou R\u00e9cidivante, de la Femme, Haute autorit\u00e9 de Sant\u00e9."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.medmal.2018.03.005","article-title":"Practice guidelines for the management of adult community-acquired urinary tract infections","volume":"48","author":"Caron","year":"2018","journal-title":"M\u00e9d. Mal. Infect."},{"key":"ref_11","unstructured":"EAU (2022). EAU Guidelines. Edn. Presented at the EAU Annual Congress Amsterdam, The Netherlands 2022, 22\/03, EAU."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1111\/acem.12171","article-title":"History and Physical Examination Plus Laboratory Testing for the Diagnosis of Adult Female Urinary Tract Infection","volume":"20","author":"Meister","year":"2013","journal-title":"Acad. Emerg. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.medmal.2017.01.007","article-title":"Proposal for shorter antibiotic therapies","volume":"47","author":"Wintenberger","year":"2017","journal-title":"M\u00e9d. Mal. Infect."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.idnow.2020.12.001","article-title":"Anti-infectious treatment duration: The SPILF and GPIP French guidelines and recommendations","volume":"51","author":"Gauzit","year":"2021","journal-title":"Infect. Dis. Now"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Bell, B.G., Schellevis, F., Stobberingh, E., Goossens, H., and Pringle, M. (2014). A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance. BMC Infect. Dis., 14.","DOI":"10.1186\/1471-2334-14-13"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"403","DOI":"10.33073\/pjm-2019-048","article-title":"Antibiotic Resistance Among Uropathogenic Escherichia coli","volume":"68","author":"Kot","year":"2019","journal-title":"Pol. J. Microbiol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Piraux, A., Faure, S., Naber, K.G., Alidjanov, J.F., and Ramond-Roquin, A. (2021). Changes in the management of urinary tract infections in women: Impact of the new recommendations on antibiotic prescribing behavior in France, between 2014 and 2019. BMC Health Serv. Res., 21.","DOI":"10.1186\/s12913-021-06653-4"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Hecker, M.T., Fox, C.J., Son, A.H., Cydulka, R.K., Siff, J.E., Emerman, C.L., Sethi, A.K., Muganda, C.P., and Donskey, C.J. (2014). Effect of a Stewardship Intervention on Adherence to Uncomplicated Cystitis and Pyelonephritis Guidelines in an Emergency Department Setting. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0087899"},{"key":"ref_19","unstructured":"Grave, E. (2017). Prise en Charge des Infections Urinaires au Service d\u2019accueil des Urgences du Centre Hospitalier de Dunkerque Selon les Recommandations de la SPILF, Universit\u00e9 du droit et de la sant\u00e9 Lille 2."},{"key":"ref_20","unstructured":"(GraphPad Software, 2020). GraphPad Software."},{"key":"ref_21","unstructured":"R Core Team (2022). R: A Language and Environment for Statistical Computing, R Core Team."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Chidiac, C., Cavallo, J.D., Cohen, R., Dupon, M., Galperine, T., Garraffo, R., Garo, B., Gauzit, R., Gavazzi, G., and Kouzan, S. (2020, December 30). Focus on the Good Use of Systemic Fluoroquinolones Administered in Adults (Ciprofloxacin, Levofloxacin, Moxifloxacin, Norfloxacin, Ofloxacin, Pefloxacin). Available online: https:\/\/www.infectiologie.com\/UserFiles\/File\/medias\/Recos\/2015-MAP-fluoroquinolones-SPILF.pdf.","DOI":"10.1016\/j.medmal.2015.07.003"},{"key":"ref_23","first-page":"650","article-title":"Risk factors for fluoroquinolone-resistant Escherichia coli in adults with community-onset febrile urinary tract infection","volume":"66","author":"Paltansing","year":"2010","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"7404095","DOI":"10.1155\/2018\/7404095","article-title":"Adherence to International Guidelines for the Treatment of Uncomplicated Urinary Tract Infections in Lebanon","volume":"2018","author":"Kabbara","year":"2018","journal-title":"Can. J. Infect. Dis. Med Microbiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"ofv159","DOI":"10.1093\/ofid\/ofv159","article-title":"Low Concordance with Guidelines for Treatment of Acute Cystitis in Primary Care","volume":"2","author":"Grigoryan","year":"2015","journal-title":"Open Forum Infect. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/s15010-014-0659-4","article-title":"Beyond antibiotic selection: Concordance with the IDSA guidelines for uncomplicated urinary tract infections","volume":"43","author":"Kim","year":"2015","journal-title":"Infection"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Zatorski, C., Zocchi, M., Cosgrove, S.E., Rand, C., Brooks, G., and May, L. (2016). A single center observational study on emergency department clinician non-adherence to clinical practice guidelines for treatment of uncomplicated urinary tract infections. BMC Infect. Dis., 16.","DOI":"10.1186\/s12879-016-1972-6"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"ofy198","DOI":"10.1093\/ofid\/ofy198","article-title":"An Assessment of Inappropriate Antibiotic Use and Guideline Adherence for Uncomplicated Urinary Tract Infections","volume":"5","author":"Durkin","year":"2018","journal-title":"Open Forum Infect. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Lutters, M., and Vogt-Ferrier, N.B. (2008). Antibiotic duration for treating uncomplicated, symptomatic lower urinary tract infections in elderly women. Cochrane Database Syst. Rev., CD001535.","DOI":"10.1002\/14651858.CD001535.pub2"},{"key":"ref_30","unstructured":"IACG (2019). No Time to Wait: Securing the Future from Drug-Resistant Infections. Report to the Secretary-General of the United Nations, IACG."},{"key":"ref_31","first-page":"686","article-title":"Antibiotic-resistant infections in primary care are symptomatic for longer and increase workload: Outcomes for patients with E. coli UTIs","volume":"56","author":"Butler","year":"2006","journal-title":"Br. J. Gen. Pract."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1093\/cid\/cit688","article-title":"Appropriate Antibiotic Use for Patients with Urinary Tract Infections Reduces Length of Hospital Stay","volume":"58","author":"Spoorenberg","year":"2014","journal-title":"Clin. Infect. Dis."},{"key":"ref_33","unstructured":"World Health Organisation (WHO) (2014). Antimicrobial Resistance: Global Report on Surveillance."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Francke, A.L., Smit, M.C., de Veer, A.J., and Mistiaen, P. (2008). Factors influencing the implementation of clinical guidelines for health care professionals: A systematic meta-review. BMC Med. Inform. Decis. Mak., 8.","DOI":"10.1186\/1472-6947-8-38"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1093\/fampra\/cmq107","article-title":"The adherence of GPs to guidelines for the diagnosis and treatment of lower urinary tract infections in women is poor","volume":"28","author":"Llor","year":"2011","journal-title":"Fam. Pract."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Grigoryan, L., Nash, S., Zoorob, R., Germanos, G.J., Horsfield, M.S., Khan, F.M., Martin, L., and Trautner, B.W. (2019). Qualitative Analysis of Primary Care Provider Prescribing Decisions for Urinary Tract Infections. Antibiotics, 8.","DOI":"10.3390\/antibiotics8020084"},{"key":"ref_37","unstructured":"Antibioclic (2020, September 16). Antibioth\u00e9raphie Rationnelle En Soins Primaires. Available online: https:\/\/antibioclic.com\/."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Yoon, C.H., Ritchie, S.R., Duffy, E.J., Thomas, M.G., McBride, S., Read, K., Chen, R., and Humphrey, G. (2019). Impact of a smartphone app on prescriber adherence to antibiotic guidelines in adult patients with community acquired pneumonia or urinary tract infections. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0211157"},{"key":"ref_39","unstructured":"(2020, November 04). VIDAL\u2014Recommandations. Available online: https:\/\/www.vidal.fr\/recommandations\/."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e25","DOI":"10.2196\/medinform.9629","article-title":"Diabetes-Related Behavior Change Knowledge Transfer to Primary Care Practitioners and Patients: Implementation and Evaluation of a Digital Health Platform","volume":"6","author":"Abidi","year":"2018","journal-title":"JMIR Med Inform."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2997","DOI":"10.1093\/jac\/dks336","article-title":"Can we improve adherence to guidelines for the treatment of lower urinary tract infection? A simple, multifaceted intervention in out-of-hours services","volume":"67","author":"Willems","year":"2012","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1093\/jac\/dkaa556","article-title":"What are the most effective community-based antimicrobial stewardship interventions in low- and middle-income countries? A narrative review","volume":"76","author":"Lam","year":"2021","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/j.sapharm.2015.08.010","article-title":"netCare, a new collaborative primary health care service based in Swiss community pharmacies","volume":"12","author":"Erni","year":"2016","journal-title":"Res. Soc. Adm. Pharm."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1017\/S1463423617000925","article-title":"Building capacity in primary care: The implementation of a novel \u2018Pharmacy First\u2019 scheme for the management of UTI, impetigo and COPD exacerbation","volume":"19","author":"Stewart","year":"2018","journal-title":"Prim. Health Care Res. Dev."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e244","DOI":"10.3399\/bjgp13X665206","article-title":"Antibiotic treatment of urinary tract infection by community pharmacists: A cross-sectional study","volume":"63","author":"Booth","year":"2013","journal-title":"Br. J. Gen. Pract."},{"key":"ref_46","unstructured":"Ministry of Solidarites and Health (2020). Arr\u00eat\u00e9 Du 6 Mars 2020 Relatif \u00e0 L\u2019autorisation Du Protocole de Coop\u00e9ration \u00ab Prise En Charge de La Pollakiurie et de La Br\u00fblure Mictionnelle Chez La Femme de 16 \u00e0 65 Ans Par l\u2019infirmier Dipl\u00f4m\u00e9 d\u2019Etat et Le Pharmacien d\u2019officine Dans Le Cadre d\u2019une Structure Pluri-Professionnelle \u00bb."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/11\/7\/976\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:54:26Z","timestamp":1760140466000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/11\/7\/976"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,20]]},"references-count":46,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["antibiotics11070976"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics11070976","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,20]]}}}