scholarly journals Why did some practices not implement new antibiotic prescribing guidelines on urinary tract infection? A cohort study and survey in NHS England primary care

2018 ◽  
Vol 74 (4) ◽  
pp. 1125-1132 ◽  
Author(s):  
Richard Croker ◽  
Alex J Walker ◽  
Ben Goldacre
Keyword(s):  
Primary Care ◽  
Urinary Tract Infection ◽  
Cohort Study ◽  
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 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 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

scholarly journals Risk of Cancer after Lower Urinary Tract Infection: A Population-Based Cohort Study

2019 ◽  
Vol 16 (3) ◽  
pp. 390 ◽  
Author(s):  
Chia-Hung Huang ◽  
Ying-Hsiang Chou ◽  
Han-Wei Yeh ◽  
Jing-Yang Huang ◽  
Shun-Fa Yang ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Cohort Study ◽  
Urinary Tract ◽  
Urinary Bladder ◽  
Tract Infection ◽  
Lower Urinary Tract ◽  
Population Based ◽  
Control Group ◽  
Lower Urinary Tract Infection ◽  
Lower Urinary

To investigate the association among lower urinary tract infection (UTI), the type and timing of antibiotic usage, and the subsequent risk of developing cancers, especially genitourinary cancers (GUC), in Taiwan. This retrospective population-based cohort study was conducted using 2009–2013 data from the Longitudinal Health Insurance Database. This study enrolled patients who were diagnosed with a UTI between 2010 and 2012. A 1:2 propensity score-matched control population without UTI served as the control group. Multivariate analysis with a multiple Cox regression model was applied to analyze the data. A total of 38,084 patients with UTI were included in the study group, and 76,168 participants without UTI were included in the control group. The result showed a higher hazard ratio of any cancer in both sexes with UTI (for males, adjusted hazard ratio (aHR) = 1.32; 95% confidence interval (CI) = 1.12–1.54; for females, aHR = 1.21; 95% CI = 1.08–1.35). Patients with UTI had a higher probability of developing new GUC than those without UTI. Moreover, the genital organs, kidney, and urinary bladder of men were significantly more affected than those of women with prior UTI. Furthermore, antibiotic treatment for more than 7 days associated the incidence of bladder cancer in men (7–13 days, aHR = 1.23, 95% CI = 0.50–3.02; >14 days, aHR = 2.73, CI = 1.32–5.64). In conclusion, UTI is significantly related to GUC and may serve as an early sign of GUC, especially in the male genital organs, prostate, kidney, and urinary bladder. During UTI treatment, physicians should cautiously prescribe antibiotics to patients.

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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