Risk factors for treatment failure in women with uncomplicated lower urinary tract infection.
Given rising antibiotic resistance and increasing use of delayed prescription for uncomplicated lower urinary tract infections (UTI), patients at risk for treatment failure should be identified early. We assessed risk factors for clinical and microbiological failure in women with lower UTI. This cas...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2021-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0256464 |
| _version_ | 1798032828518105088 |
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| author | Romain Martischang Maciek Godycki-Ćwirko Anna Kowalczyk Katarzyna Kosiek Adi Turjeman Tanya Babich Shachaf Shiber Leonard Leibovici Elodie von Dach Stephan Harbarth Angela Huttner |
| author_facet | Romain Martischang Maciek Godycki-Ćwirko Anna Kowalczyk Katarzyna Kosiek Adi Turjeman Tanya Babich Shachaf Shiber Leonard Leibovici Elodie von Dach Stephan Harbarth Angela Huttner |
| author_sort | Romain Martischang |
| collection | DOAJ |
| description | Given rising antibiotic resistance and increasing use of delayed prescription for uncomplicated lower urinary tract infections (UTI), patients at risk for treatment failure should be identified early. We assessed risk factors for clinical and microbiological failure in women with lower UTI. This case-control study nested within a randomized clinical trial included all women in the per-protocol population (PPP), those in the PPP with microbiologically confirmed UTI, and those in the PPP with UTI due to Escherichia coli. Cases were women who experienced clinical and/or microbiologic failure; controls were those who did not. Risk factors for failure were assessed using multivariate logistic regression. In the PPP, there were 152 clinical cases for 307 controls. Among 340 women with microbiologically confirmed UTI, 126 and 102 cases with clinical and microbiological failure were considered with, respectively, 214 and 220 controls. Age ≥52 years was independently associated with clinical (adjusted OR 3.01; 95%CI 1.84-4.98) and microbiologic failure (aOR 2.55; 95%CI 1.54-4.25); treatment with fosfomycin was associated with clinical failure (aOR 2.35; 95%CI 1.47-3.80). The association with age persisted among all women, and women with E. coli-related UTI. Diabetes was not an independent risk factor, nor were other comorbidities. Postmenopausal age emerged as an independent risk factor for both clinical and microbiological treatment failure in women with lower UTI and should be considered to define women at-risk for non-spontaneous remission, and thus for delayed antibiotic therapy; diabetes mellitus was not associated with failure. |
| first_indexed | 2024-04-11T20:20:04Z |
| format | Article |
| id | doaj.art-5b1ac2ce7ec7499ca1f81860f6206a7c |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-11T20:20:04Z |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-5b1ac2ce7ec7499ca1f81860f6206a7c2022-12-22T04:04:49ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01168e025646410.1371/journal.pone.0256464Risk factors for treatment failure in women with uncomplicated lower urinary tract infection.Romain MartischangMaciek Godycki-ĆwirkoAnna KowalczykKatarzyna KosiekAdi TurjemanTanya BabichShachaf ShiberLeonard LeiboviciElodie von DachStephan HarbarthAngela HuttnerGiven rising antibiotic resistance and increasing use of delayed prescription for uncomplicated lower urinary tract infections (UTI), patients at risk for treatment failure should be identified early. We assessed risk factors for clinical and microbiological failure in women with lower UTI. This case-control study nested within a randomized clinical trial included all women in the per-protocol population (PPP), those in the PPP with microbiologically confirmed UTI, and those in the PPP with UTI due to Escherichia coli. Cases were women who experienced clinical and/or microbiologic failure; controls were those who did not. Risk factors for failure were assessed using multivariate logistic regression. In the PPP, there were 152 clinical cases for 307 controls. Among 340 women with microbiologically confirmed UTI, 126 and 102 cases with clinical and microbiological failure were considered with, respectively, 214 and 220 controls. Age ≥52 years was independently associated with clinical (adjusted OR 3.01; 95%CI 1.84-4.98) and microbiologic failure (aOR 2.55; 95%CI 1.54-4.25); treatment with fosfomycin was associated with clinical failure (aOR 2.35; 95%CI 1.47-3.80). The association with age persisted among all women, and women with E. coli-related UTI. Diabetes was not an independent risk factor, nor were other comorbidities. Postmenopausal age emerged as an independent risk factor for both clinical and microbiological treatment failure in women with lower UTI and should be considered to define women at-risk for non-spontaneous remission, and thus for delayed antibiotic therapy; diabetes mellitus was not associated with failure.https://doi.org/10.1371/journal.pone.0256464 |
| spellingShingle | Romain Martischang Maciek Godycki-Ćwirko Anna Kowalczyk Katarzyna Kosiek Adi Turjeman Tanya Babich Shachaf Shiber Leonard Leibovici Elodie von Dach Stephan Harbarth Angela Huttner Risk factors for treatment failure in women with uncomplicated lower urinary tract infection. PLoS ONE |
| title | Risk factors for treatment failure in women with uncomplicated lower urinary tract infection. |
| title_full | Risk factors for treatment failure in women with uncomplicated lower urinary tract infection. |
| title_fullStr | Risk factors for treatment failure in women with uncomplicated lower urinary tract infection. |
| title_full_unstemmed | Risk factors for treatment failure in women with uncomplicated lower urinary tract infection. |
| title_short | Risk factors for treatment failure in women with uncomplicated lower urinary tract infection. |
| title_sort | risk factors for treatment failure in women with uncomplicated lower urinary tract infection |
| url | https://doi.org/10.1371/journal.pone.0256464 |
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