Antimicrobial Management of Urinary Tract Infections: Insights from a Tertiary Care Hospital in Oman.

Objectives: To assess treatment initiatives in symptomatic and asymptomatic urinary tract infection (UTI) cases, identify effective antibiotics based on culture reports, and evaluate secondary factors such as symptoms, urine white blood cells, culture correlation, prevalent microbial flora, empirical antibiotic efficacy, and prevalence of multidrug resistance (MDR).

Methods: A retrospective analysis of urological cases with microbial growth on culture was conducted. Data on demographics, symptoms, urinalysis, culture analysis, antibiotic sensitivity, and MDR status were collected and statistically analyzed.

Results: Out of 223 cases included in the study, 191 were symptomatic and 32 were asymptomatic. Escherichia coli was the most common pathogenic organism (55.6%). Nitrofurantoin exhibited high efficacy (75.4% in symptomatic and 78.1% in asymptomatic patients), with no significant difference between the two groups in MDR bacteria prevalence (p = 0.377) or positive follow-up cultures (p = 0.687).

Conclusions: Nitrofurantoin was highly effective for UTIs; however, multidrug-resistant strains remain a concern. With limited access to minimum inhibitory concentration results and culture sensitivity tests during the initial patient visit, physicians prescribing first-line treatments for suspected cases of resistance must carefully evaluate clinical presentation, patient history, and local resistance patterns. Subsequent treatments should be based on culture sensitivity results and clinical guidelines. This study is particularly relevant in the Gulf Cooperation Council region due to its distinct epidemiological and clinical landscape.