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TOPLINE:
The prevalence of recurrent urinary tract infections (rUTIs) and the usage of antibiotics for prevention are substantial amongst girls in Wales, notably amongst these over the age of 57 years. A excessive degree of resistance to 2 beneficial antibiotics was noticed, suggesting that extra frequent urine cultures might higher information antibiotic choice for remedy and prophylaxis.
METHODOLOGY:
- The researchers performed a retrospective cross-sectional examine utilizing a big databank of sufferers in Wales to explain the traits and urine profiles of ladies with rUTIs between 2010 and 2022.
- They created two cohorts: One with 92,213 girls (median age, 60 years) who skilled rUTIs, outlined as two or extra acute episodes inside 6 months or three or extra acute episodes inside 12 months.
- One other cohort comprised of 26,862 girls (median age, 71 years) have been prescribed prophylactic antibiotics, which was outlined as receiving three or extra consecutive prescriptions of the identical UTI-specific antibiotic (trimethoprim, nitrofurantoin, or cefalexin), with intervals of 21-56 days between prescriptions.
- Urine culture leads to the 12 months earlier than a rUTI prognosis and 18 months earlier than prophylactic antibiotic initiation and all urine tradition outcomes inside 7 days of an acute UTI have been analyzed to evaluate antibiotic resistance patterns.
TAKEAWAY:
- Total, 6% of ladies had rUTIs, 1.7% of which have been prescribed prophylactic antibiotics with proportions growing sharply after age 57.
- Practically half of the ladies (49%) who have been prescribed a prophylactic antibiotic certified as having rUTIs within the 18 months earlier than initiation.
- This examine confirmed that 80.8% of ladies with rUTIs had a urine tradition outcome documented within the 12 months previous the prognosis.
- Greater than half (64%) of the ladies taking prophylactic antibiotics had a urine tradition outcome documented earlier than beginning remedy, and 18% of these prescribed trimethoprim had resistance to the antibiotic.
IN PRACTICE:
“Extra frequent urine cultures within the workup of rUTI prognosis and prophylactic antibiotic initiation might higher inform antibiotic alternative,” the authors wrote.
SOURCE:
The examine was led by Leigh Sanyaolu, BSc (Hons), MRCS, MRCGP, PGDip, a common practitioner from the Division of Inhabitants Drugs and PRIME Centre Wales at Cardiff College in Cardiff, and was printed online in the British Journal of Common Observe.
LIMITATIONS:
The examine’s reliance on digital well being information might have led to coding errors and lacking information. The prognosis of UTIs might have been troublesome in older girls with elevated frailty as they will have fewer particular signs and asymptomatic bacteriuria, which might be misdiagnosed as a UTI.
DICLOSURES:
This work was supported by Well being and Care Analysis Wales. The authors declared no conflicts of curiosity.
This text was created utilizing a number of editorial instruments, together with AI, as a part of the method. Human editors reviewed this content material earlier than publication.
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