Antibiotic prescribing and urinary tract infection

2002 ◽  
Vol 20 (6) ◽  
pp. 407-411 ◽  
Author(s):  
Sevgi Canbaz ◽  
Yildiz Peksen ◽  
Ahmet Tevfik Sunter ◽  
Hakan Leblebicioglu ◽  
Mustafa Sunbul
2009 ◽  
Vol 16 (6) ◽  
pp. 500-507 ◽  
Author(s):  
Jeffrey M. Caterino ◽  
Sarah Grace Weed ◽  
Janice A. Espinola ◽  
Carlos A. Camargo, Jr

2017 ◽  
Vol 38 (8) ◽  
pp. 998-1001 ◽  
Author(s):  
Taniece Eure ◽  
Lisa L. LaPlace ◽  
Richard Melchreit ◽  
Meghan Maloney ◽  
Ruth Lynfield ◽  
...  

We assessed the appropriateness of initiating antibiotics in 49 nursing home (NH) residents receiving antibiotics for urinary tract infection (UTI) using 3 published algorithms. Overall, 16 residents (32%) received prophylaxis, and among the 33 receiving treatment, the percentage of appropriate use ranged from 15% to 45%. Opportunities exist for improving UTI antibiotic prescribing in NH.Infect Control Hosp Epidemiol 2017;38:998–1001


2017 ◽  
Vol 67 (665) ◽  
pp. e830-e841 ◽  
Author(s):  
Christopher C Butler ◽  
Nick Francis ◽  
Emma Thomas-Jones ◽  
Carl Llor ◽  
Emily Bongard ◽  
...  

BackgroundRegional variations in the presentation of uncomplicated urinary tract infection (UTI) and pathogen sensitivity to antibiotics have been cited as reasons to justify differences in how the infections are managed, which includes the prescription of broad-spectrum antibiotics.AimTo describe presentation and management of UTI in primary care settings, and explore the association with patient recovery, taking microbiological findings and case mix into account.Design and settingProspective observational study of females with symptoms of uncomplicated UTI presenting to primary care networks in England, Wales, the Netherlands, and Spain.MethodClinicians recorded history, symptom severity, management, and requested mid-stream urine culture. Participants recorded, in a diary, symptom severity each day for 14 days. Time to recovery was compared between patient characteristics and between countries using two-level Cox proportional hazards models, with patients nested within practices.ResultsIn total, 797 females attending primary care networks in England (n = 246, 30.9% of cohort), Wales (n = 213, 26.7%), the Netherlands (n = 133, 16.7%), and Spain (n = 205, 25.7%) were included. In total, 259 (35.8%, 95% confidence interval 32.3 to 39.2) of 726 females for whom there was a result were urine culture positive for UTI. Pathogens and antibiotic sensitivities were similar. Empirical antibiotics were prescribed for 95.1% in England, 92.9% in Wales, 95.1% in Spain, and 59.4% in the Netherlands There were no meaningful differences at a country network level before and after controlling for severity, prior UTIs, and antibiotic prescribing.ConclusionVariation in presentation and management of uncomplicated UTI at a country primary care network level is clinically unwarranted and highlights a lack of consensus concerning optimal symptom control and antibiotic prescribing.


PLoS ONE ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. e0190521 ◽  
Author(s):  
Haroon Ahmed ◽  
Daniel Farewell ◽  
Hywel M. Jones ◽  
Nick A. Francis ◽  
Shantini Paranjothy ◽  
...  

Author(s):  
Abbye W. Clark ◽  
Michael J. Durkin ◽  
Margaret A. Olsen ◽  
Matthew Keller ◽  
Yinjiao Ma ◽  
...  

Abstract Objective: To examine rural–urban differences in temporal trends and risk of inappropriate antibiotic use by agent and duration among women with uncomplicated urinary tract infection (UTI). Design: Observational cohort study. Methods: Using the IBM MarketScan Commercial Database (2010–2015), we identified US commercially insured women aged 18–44 years coded for uncomplicated UTI and prescribed an oral antibiotic agent. We classified antibiotic agents and durations as appropriate versus inappropriate based on clinical guidelines. Rural–urban status was defined by residence in a metropolitan statistical area. We used modified Poisson regression to determine the association between rural–urban status and inappropriate antibiotic receipt, accounting for patient- and provider-level characteristics. We used multivariable logistic regression to estimate trends in antibiotic use by rural–urban status. Results: Of 670,450 women with uncomplicated UTI, a large proportion received antibiotic prescriptions for inappropriate agents (46.7%) or durations (76.1%). Compared to urban women, rural women were more likely to receive prescriptions with inappropriately long durations (adjusted risk ratio 1.10, 95% CI, 1.10–1.10), which was consistent across subgroups. From 2011 to 2015, there was slight decline in the quarterly proportion of patients who received inappropriate agents (48.5% to 43.7%) and durations (78.3% to 73.4%). Rural–urban differences varied over time by agent (duration outcome only), geographic region, and provider specialty. Conclusions: Inappropriate antibiotic prescribing is quite common for the treatment of uncomplicated UTI. Rural women are more likely to receive inappropriately long antibiotic durations. Antimicrobial stewardship interventions are needed to improve outpatient UTI antibiotic prescribing and to reduce unnecessary exposure to antibiotics, particularly in rural settings.


Author(s):  
Joan A Casey ◽  
Kara E Rudolph ◽  
Sarah C Robinson ◽  
Katia Bruxvoort ◽  
Eva Raphael ◽  
...  

Abstract Background Urinary tract infection (UTI) accounts for a substantial portion of outpatient visits and antibiotic prescriptions in the United States (US). Few studies have considered sociodemographic factors including low socioeconomic status (SES)–which may increase residential crowding, inappropriate antibiotic prescribing, or co-morbidities–as UTI or multi-drug resistant (MDR) UTI risk factors. Methods We used 2015-2017 electronic health record data from two California healthcare systems to assess whether three sociodemographic factors–use of Medicaid, use of an interpreter, and census tract-level deprivation–were associated with overall UTI or MDR UTI. UTI resistant to ≥3 antibiotic classes were considered MDR. Results Analyses included 601,352 UTI cases, 1,303,455 controls, and 424,977 urinary E. coli isolates from Kaiser Permanente Southern California (KPSC) and Sutter Health in Northern California. MDR prevalence was 10.4% at KPSC and 12.8% at Sutter Health. All three sociodemographic factors (i.e., use of Medicaid, using an interpreter, and community deprivation) were associated increased risk of MDR UTI. For example, using an interpreter was associated with a 36% (RR = 1.36, 95% CI: 1.31, 1.40) and a 28% (RR = 1.28, 95% CI: 1.22, 1.34) increased risk of MDR UTI at KPSC and Sutter Health, respectively, adjusted for SES and other potential confounding variables. The three sociodemographic factors were only weakly associated with UTI overall. Conclusions We found low SES and use of an interpreter as novel risk factors for MDR UTI in the US.


Sign in / Sign up

Export Citation Format

Share Document