scholarly journals Incidence and antibiotic prescribing for clinically diagnosed urinary tract infection in older adults in UK primary care, 2004-2014

PLoS ONE ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. e0190521 ◽  
Author(s):  
Haroon Ahmed ◽  
Daniel Farewell ◽  
Hywel M. Jones ◽  
Nick A. Francis ◽  
Shantini Paranjothy ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antibiotic Prescribing

scholarly journals Variations in presentation, management, and patient outcomes of urinary tract infection: a prospective four-country primary care observational cohort study

2017 ◽  
Vol 67 (665) ◽  
pp. e830-e841 ◽  
Author(s):  
Christopher C Butler ◽  
Nick Francis ◽  
Emma Thomas-Jones ◽  
Carl Llor ◽  
Emily Bongard ◽  
...  
Keyword(s):  
Primary Care ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
The Netherlands ◽  
Symptom Severity ◽  
Urine Culture ◽  
Symptom Control ◽  
Antibiotic Prescribing ◽  
Uncomplicated Urinary Tract Infection

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.

scholarly journals Prescribing Without Guidance: Antibiotic Prescribing for Male Urinary Tract Infection (UTI) in Primary Care

2015 ◽  
Vol 2 (suppl_1) ◽  
Author(s):  
Haley K. Holmer ◽  
Miriam R. Elman ◽  
Charlesnika Evans ◽  
Katie J. Suda ◽  
Jessina C. Mcgregor
Keyword(s):  
Primary Care ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antibiotic Prescribing

The Benefits and Harms of Antibiotic Prophylaxis for Urinary Tract Infection in Older Adults

2021 ◽  
Author(s):  
Bradley J Langford ◽  
Kevin A Brown ◽  
Christina Diong ◽  
Alex Marchand-Austin ◽  
Kwaku Adomako ◽  
...  
Keyword(s):  
Older Adults ◽  
Urinary Tract Infection ◽  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antibiotic Prophylaxis ◽  
Bloodstream Infection ◽  
Antibiotic Treatment ◽  
Positive Culture ◽  
Clostridioides Difficile

Abstract Background The role of antibiotics in preventing urinary tract infection (UTI) in older adults is unknown. We sought to quantify the benefits and risks of antibiotic prophylaxis among older adults. Methods We conducted a matched cohort study comparing older adults (≥66 years) receiving antibiotic prophylaxis, defined as antibiotic treatment for ≥30 days starting within 30 days of a positive culture, with patients with positive urine cultures who received antibiotic treatment but did not receive prophylaxis. We matched each prophylaxis recipient to 10 nonrecipients based on organism, number of positive cultures, and propensity score. Outcomes included (1) emergency department (ED) visit or hospitalization for UTI, sepsis, or bloodstream infection within 1 year; (2) acquisition of antibiotic resistance in urinary tract pathogens; and (3) antibiotic-related complications. Results Overall, 4.7% (151/3190) of UTI prophylaxis patients and 3.6% (n = 1092/30 542) of controls required an ED visit or hospitalization for UTI, sepsis, or bloodstream infection (hazard ratio [HR], 1.33; 95% confidence interval [CI], 1.12–1.57). Acquisition of antibiotic resistance to any urinary antibiotic (HR, 1.31; 95% CI, 1.18–1.44) and to the specific prophylaxis agent (HR, 2.01; 95% CI, 1.80–2.24) was higher in patients receiving prophylaxis. While the overall risk of antibiotic-related complications was similar between groups (HR, 1.08; 95% CI, .94–1.22), the risk of Clostridioides  difficile and general medication adverse events was higher in prophylaxis recipients (HR [95% CI], 1.56 [1.05–2.23] and 1.62 [1.11–2.29], respectively). Conclusions Among older adults with UTI, the harms of long-term antibiotic prophylaxis may outweigh their benefits.

scholarly journals Urinary Tract Infection and Asymptomatic Bacteriuria in Older Adults

2017 ◽  
Vol 31 (4) ◽  
pp. 673-688 ◽  
Author(s):  
Nicolas W. Cortes-Penfield ◽  
Barbara W. Trautner ◽  
Robin L.P. Jump
Keyword(s):  
Older Adults ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Asymptomatic Bacteriuria

National Trends in Emergency Department Antibiotic Prescribing for Elders with Urinary Tract Infection, 1996-2005

2009 ◽  
Vol 16 (6) ◽  
pp. 500-507 ◽  
Author(s):  
Jeffrey M. Caterino ◽  
Sarah Grace Weed ◽  
Janice A. Espinola ◽  
Carlos A. Camargo, Jr
Keyword(s):  
Emergency Department ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antibiotic Prescribing ◽  
National Trends
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