If you’ve ever dealt with a urinary tract infection (UTI), either personally or as a parent caring for a child, you know how uncomfortable and disruptive it can be. But what if the treatment prescribed isn’t actually the right one?
A new study from Singapore reveals that more than half of patients treated for uncomplicated UTIs in primary care settings were given inappropriate antibiotics. The implications go beyond delayed recovery. This trend could contribute to the growing threat of antibiotic resistance, which affects not just individuals but entire communities, including children.
What the Study Found
Researchers reviewed data from 369 patients (median age 58, mostly Chinese) seen at seven primary care clinics between January and June 2023. Of these, 53.4 percent were prescribed antibiotics that did not align with the Ministry of Health’s 2023 clinical guidelines for uncomplicated UTI treatment.
This rate is comparable to those reported in the United States (52.9%) and Australia (45.6%), and higher than South Korea (26.9%) but lower than Switzerland (84.7%).
Why the Prescriptions Were Inappropriate
UTI Cases in Singapore Are Treated with the Wrong Antibiotics
The study identified three main reasons for the inappropriate prescriptions of the UTI cases in Singapore:
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69% deviated from updated MOH clinical guidelines
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18% resulted from an incorrect diagnosis
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13% involved both a wrong diagnosis and guideline deviation
The most commonly prescribed antibiotics were amoxicillin/clavulanate (47.2%) and nitrofurantoin (32.8%), though not all prescriptions were considered appropriate.
What’s Behind These Errors?
Several factors increased the chances of receiving the wrong treatment:
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Patients with antibiotic allergies were 2.5 times more likely to be prescribed inappropriate medications
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Consultations involving multiple complaints or diagnoses were linked to higher misdiagnosis rates
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Some clinics had significantly higher odds of inappropriate prescribing compared to others
The researchers also noted that outdated guidelines may have contributed to the trend. Singapore’s updated antibiotic guidelines were only released in November 2023 after the study period. This highlights the importance of timely implementation and education.
Why This Matters for Families
UTIs are common, especially among women and children. When not treated correctly, they can lead to complications, prolonged discomfort, and a higher risk of developing antibiotic-resistant infections.
For parents, this means being more aware and proactive during consultations. It’s important to:
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Share complete and accurate symptom details
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Mention any known drug allergies
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Ask your doctor whether the chosen antibiotic is the most appropriate option
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Be open to follow-up visits if the diagnosis isn’t clear
What Can Be Done
To reduce inappropriate antibiotic use, the researchers recommend:
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Using clinical decision support tools
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Adopting shared decision-making practices
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Offering continuing medical education to healthcare providers
These steps can help improve prescribing practices, ensure better outcomes for patients, and reduce the risk of antibiotic resistance in the wider community.
Final Thoughts
UTIs are common and treatable, but only when diagnosed correctly and managed with the right antibiotics. This new research highlights a pressing issue in Singapore’s primary care system: even when the symptoms seem straightforward, the treatment might miss the mark.
For parents, this is a timely reminder to be informed and engaged during medical visits. Ask questions. Share clear symptom histories. And when needed, follow up. These small actions can make a big difference, not just for your child’s recovery, but for slowing the spread of antibiotic resistance in the long run.
With the release of updated national guidelines and growing awareness around this issue, healthcare providers and families have an opportunity to work together for safer, more effective care.
References
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Lim P, Goh L, Ong WY, et al. Inappropriate antibiotic prescriptions for uncomplicated urinary tract infections in primary care in Singapore: a multicentre point prevalence study. Scientific Reports. 2025;15:15055.
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Tan E, Lim M, et al. Use of antibiotics for UTIs in Asia-Pacific: comparison of prescribing practices. BMC Family Practice. 2020;21:125.
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Infect Dis Health. 2019;24:75–81.
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PLoS One. 2022;17:e0277713.
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Infect Dis Clin Pract. 2024;32:e1385.
