Prior antibiotics and risk of antibiotic-resistant community-acquired urinary tract infection: a case-control study.
BACKGROUND: To assess the effect of previous antibiotic use on the risk of a resistant Escherichia coli urinary tract infection (UTI), we undertook a case-control study with prospective measurement of outcomes in 10 general practices in the UK. METHODS: Urinary samples from all patients with sympto...
| Main Authors: | , , , , , |
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| Format: | Journal article |
| Language: | English |
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2007
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| _version_ | 1826282363741536256 |
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| author | Hillier, S Roberts, Z Dunstan, F Butler, C Howard, A Palmer, S |
| author_facet | Hillier, S Roberts, Z Dunstan, F Butler, C Howard, A Palmer, S |
| author_sort | Hillier, S |
| collection | OXFORD |
| description | BACKGROUND: To assess the effect of previous antibiotic use on the risk of a resistant Escherichia coli urinary tract infection (UTI), we undertook a case-control study with prospective measurement of outcomes in 10 general practices in the UK. METHODS: Urinary samples from all patients with symptoms suggestive of UTIs were sought, and those with a laboratory-proven E. coli infection were interviewed and their medical records examined. Case patients were those with ampicillin- or trimethoprim-resistant infections and control patients had infections that were susceptible to antibiotics, including ampicillin and trimethoprim. RESULTS: Risk of ampicillin-resistant E. coli infection in 903 patients was associated with amoxicillin prescriptions of >or=7 days duration in the previous 1 month [odds ratio (OR)=3.91, 95% CI 1.64-9.34] and previous 2-3 months (2.29, 1.12-4.70) before illness onset. For prescriptions <7 days duration, there was no statistically significant association. Higher doses of amoxicillin were associated with lower risk of ampicillin resistance. For trimethoprim-resistant E. coli infections, the OR was 8.44 (3.12-22.86) for prescriptions of trimethoprim of >or=7 days in the previous month and 13.91 (3.32-58.31) for the previous 2-3 months. For trimethoprim prescriptions of <7 days, the OR was 4.03 (1.69-9.59) for the previous month but prescribing in earlier periods was not significantly associated with resistance. CONCLUSIONS: Within the community setting, exposure to antibiotics is a strong risk factor for a resistant E. coli UTI. High-dose, shorter-duration antibiotic regimens may reduce the pressure on the emergence of antibiotic resistance. |
| first_indexed | 2024-03-07T00:42:43Z |
| format | Journal article |
| id | oxford-uuid:839bffb4-f67b-4e8f-8838-2af82d898bf4 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T00:42:43Z |
| publishDate | 2007 |
| record_format | dspace |
| spelling | oxford-uuid:839bffb4-f67b-4e8f-8838-2af82d898bf42022-03-26T21:45:19ZPrior antibiotics and risk of antibiotic-resistant community-acquired urinary tract infection: a case-control study.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:839bffb4-f67b-4e8f-8838-2af82d898bf4EnglishSymplectic Elements at Oxford2007Hillier, SRoberts, ZDunstan, FButler, CHoward, APalmer, S BACKGROUND: To assess the effect of previous antibiotic use on the risk of a resistant Escherichia coli urinary tract infection (UTI), we undertook a case-control study with prospective measurement of outcomes in 10 general practices in the UK. METHODS: Urinary samples from all patients with symptoms suggestive of UTIs were sought, and those with a laboratory-proven E. coli infection were interviewed and their medical records examined. Case patients were those with ampicillin- or trimethoprim-resistant infections and control patients had infections that were susceptible to antibiotics, including ampicillin and trimethoprim. RESULTS: Risk of ampicillin-resistant E. coli infection in 903 patients was associated with amoxicillin prescriptions of >or=7 days duration in the previous 1 month [odds ratio (OR)=3.91, 95% CI 1.64-9.34] and previous 2-3 months (2.29, 1.12-4.70) before illness onset. For prescriptions <7 days duration, there was no statistically significant association. Higher doses of amoxicillin were associated with lower risk of ampicillin resistance. For trimethoprim-resistant E. coli infections, the OR was 8.44 (3.12-22.86) for prescriptions of trimethoprim of >or=7 days in the previous month and 13.91 (3.32-58.31) for the previous 2-3 months. For trimethoprim prescriptions of <7 days, the OR was 4.03 (1.69-9.59) for the previous month but prescribing in earlier periods was not significantly associated with resistance. CONCLUSIONS: Within the community setting, exposure to antibiotics is a strong risk factor for a resistant E. coli UTI. High-dose, shorter-duration antibiotic regimens may reduce the pressure on the emergence of antibiotic resistance. |
| spellingShingle | Hillier, S Roberts, Z Dunstan, F Butler, C Howard, A Palmer, S Prior antibiotics and risk of antibiotic-resistant community-acquired urinary tract infection: a case-control study. |
| title | Prior antibiotics and risk of antibiotic-resistant community-acquired urinary tract infection: a case-control study. |
| title_full | Prior antibiotics and risk of antibiotic-resistant community-acquired urinary tract infection: a case-control study. |
| title_fullStr | Prior antibiotics and risk of antibiotic-resistant community-acquired urinary tract infection: a case-control study. |
| title_full_unstemmed | Prior antibiotics and risk of antibiotic-resistant community-acquired urinary tract infection: a case-control study. |
| title_short | Prior antibiotics and risk of antibiotic-resistant community-acquired urinary tract infection: a case-control study. |
| title_sort | prior antibiotics and risk of antibiotic resistant community acquired urinary tract infection a case control study |
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