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Labs exaggerate resistance in UTIs

Antibiotic resistance in women with acute urinary tract infections is much less common in practice than would be expected from laboratory tests, new research concludes.

The Health Protection Agency study found only one woman in 23 with an uncomplicated, community-acquired UTI reconsulted because of antibiotic resistance. Yet an analysis of urine samples taken from 448 women with UTIs found 14 per cent showed resistance to trimethoprim.

Writing in the Journal of Anti-microbial Resistance, the resear-chers said sending all samples for testing was unnecessary, as '23 women require microbiological investigation to prevent one reconsultation from resistance-based treatment failure'.

Study leader Dr Cliodna McNulty, head of the Health Protection Agency's primary care unit, said submission of urine samples for laboratory testing was 'variable' among GPs, despite existing HPA guidelines suggesting routine urine culture was unnecessary.

She added: 'GPs need not routinely test all urine samples for resistance to trimethoprim. We recommend they use empirical treatment, then if the patient comes back, treat with another antibiotic.'

Dr Ian Williamson, senior lecturer in general practice at the University of Southampton, said: 'It is a surprising finding because generally, the rate of antibiotic resistance is rising, especially in primary care populations. But it's still important to underline guidelines on the judicious use of antibiotics.'

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