Drug therapy and cost analysis of urinary tract infections in a tertiary care teaching hospital in Nepal

Background: Urinary tract infection (UTI) is the most common infection caused by the presence and growth of pathogenic microorganisms within the human urinary system into the lower and upper genito-urinary tract. UTI continues to be major health problems in developing countries like Nepal. Methods: A prospective observational study was conducted from June 2019 to November 2019 in the outpatient and inpatient department of Manipal teaching hospital. The face-to-face interview was adopted in 137 UTI patients with the census sampling technique. Results: A total of 137 patients (121 out-patients and 16 in-patients), 82 (59.85%) female, and 55 (40.15%) males were enrolled in which UTI was observed in more than half of the sample in the aged group of 25-54. Escherichia coli was the most common uropathogens isolated whereas dysuria was the most common presenting symptom among the patients. Cefixime 200 mg followed by nitrofurantoin 100 mg was the most commonly prescribed medicine for UTI. Disodium hydrogen 1.40 g oral liquid, pantoprazole 40 mg tablet, and multivitamins were commonly prescribed supportive medications. The empirically prescribed average cost was Nepalese rupee (NRs.) 820.44 whereas the total definitive average cost was NRs. 305.54. The average cost of medical management for in-patients was NRs. 2316.55 including registration, urine analysis, investigation bed charge, and other consumable charges as well as discharge medicine cost. Conclusions: With lower cost, higher sensitivity, and high prescription, cefixime, and nitrofurantoin could be better drugs for the management of UTI among outpatient department (OPD) patients while ceftriaxone could be better for in-patients.