In the Netherlands antibiotics still effective in urinary tract infection

The micro organism frequently causing cystitis and other urinary tract infections shows worldwide increasing resistance against antibiotics. The Netherlands is an exception, however. Dutch GPs adhere strictly to the guideline concerning urinary tract infection published by the Dutch college of GPs. This proves to be successful, as shown in a recently published annual report and research article published by scientists from NIVEL and the Maastricht University Medical Center in The Journal of Antimicrobial Chemotherapy.

Cystitis and other urinary tract infections are the most prevalent infections in general practice. Especially for women it is a frequently encountered problem. The infections are mostly treated with antibiotics, but the bacterium Escherichia coli – mostly causing these infections – shows increasing resistance worldwide. Remarkably in the Netherlands resistance against the most frequently prescribed antibiotic in women (Nitrofurantoin) has not increased during the past five years, as shown in research performed by the Dutch Sentinel General Practice Network (NIVEL) in cooperation with Maastricht University Medical Center.

Guideline adherance
“Increasing antibiotic resistance has been prevented by strict adherence by Dutch GPs to the guideline concerning urinary tract infections published by the Dutch College of GPs,” says project leader, epidemiologist and GP Gé Donker. “The percentage of ‘extended-spectrum ß-lactamases’ (ESBLs), multiresistant bacteria, resistant to almost all antibiotics, increased, but was limited to 1%. However, 99% of Escherichia Coli in the urine specimen of women with urinary tract infections remained sensitive to the most frequently prescribed drug nitrofurantoin. This is good news for women, who experience urinary tract infections five times as often as men. Strict guideline adherence and completing antibiotic courses, also after symptoms have disappeared, is important to prevent increasing resistance to antibiotics.”

CMR Sentinel General Practice Network
The Continuous Morbidity Registration (CMR) Sentinel General Practice Network is constituted by a group of 57 Dutch GPs in 42 practices. The patient population covers 0.8% of the Dutch population and is nationally representative by regional distribution and population density. The sentinel GPs report weekly or annually about a number of diseases and/or interventions not covered by routine registrations. The CMR sentinel network exist since 1970.