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Recurrent urinary tract infections and prophylactic antibiotic use in women: a cross-sectional study in primary care

Leigh Sanyaolu Orcid Logo, Victoria Best, Rebecca Cannings-John, Fiona Wood, Adrian Edwards, Ashley Akbari Orcid Logo, Gail Hayward, Haroon Ahmed

British Journal of General Practice, Volume: 74, Issue: 746, Pages: e619 - e627

Swansea University Authors: Victoria Best, Ashley Akbari Orcid Logo

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DOI (Published version): 10.3399/bjgp.2024.0015

Abstract

Background Despite the considerable morbidity caused by recurrent urinary tract infections (rUTIs), and the wider personal and public health implications from frequent antibiotic use, few studies adequately describe the prevalence and characteristics of women with rUTIs or those who use prophylactic...

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Published in: British Journal of General Practice
ISSN: 0960-1643 1478-5242
Published: Royal College of General Practitioners 2024
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URI: https://cronfa.swan.ac.uk/Record/cronfa66931
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Only 49.0% (n =13 149/N = 26 862) of users of prophylactic antibiotics met the definition of rUTIs before initiation. The study found that 80.8% (n = 44 947/N = 55 652) of women with rUTIs had a urine culture result in the preceding 12 months with high rates of resistance to trimethoprim and amoxicillin. Of women taking prophylactic antibiotics, 64.2% (n = 9926/N = 15 455) had a urine culture result before initiation and 18.5% (n = 320/N = 1730) of women prescribed trimethoprim had resistance to it on the antecedent sample.Conclusion A substantial proportion of women had rUTIs or incident prophylactic antibiotic use. However, 64.2% (n = 9926/N = 15 455) of women had urine cultured before starting prophylaxis. There was a high proportion of cultured bacteria resistant to two antibiotics used for rUTI prevention and evidence of resistance to the prescribed antibiotic. More frequent urine cultures for rUTI diagnosis and before prophylactic antibiotic initiation could better inform antibiotic choices.</abstract><type>Journal Article</type><journal>British Journal of General Practice</journal><volume>74</volume><journalNumber>746</journalNumber><paginationStart>e619</paginationStart><paginationEnd>e627</paginationEnd><publisher>Royal College of General Practitioners</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0960-1643</issnPrint><issnElectronic>1478-5242</issnElectronic><keywords>anti-infective agents; bacterial; drug resistance; electronic health records; primary health care; urinary; urinary tract infections</keywords><publishedDay>1</publishedDay><publishedMonth>9</publishedMonth><publishedYear>2024</publishedYear><publishedDate>2024-09-01</publishedDate><doi>10.3399/bjgp.2024.0015</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>This work was supported by the Welsh Government through Health and Care Research Wales (NIHR-FS-2021-LS to Leigh Sanyaolu).</funders><projectreference/><lastEdited>2024-09-13T14:10:29.9624798</lastEdited><Created>2024-07-03T13:35:18.1233669</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Health Data Science</level></path><authors><author><firstname>Leigh</firstname><surname>Sanyaolu</surname><orcid>0000-0002-6762-6986</orcid><order>1</order></author><author><firstname>Victoria</firstname><surname>Best</surname><order>2</order></author><author><firstname>Rebecca</firstname><surname>Cannings-John</surname><order>3</order></author><author><firstname>Fiona</firstname><surname>Wood</surname><order>4</order></author><author><firstname>Adrian</firstname><surname>Edwards</surname><order>5</order></author><author><firstname>Ashley</firstname><surname>Akbari</surname><orcid>0000-0003-0814-0801</orcid><order>6</order></author><author><firstname>Gail</firstname><surname>Hayward</surname><order>7</order></author><author><firstname>Haroon</firstname><surname>Ahmed</surname><order>8</order></author></authors><documents><document><filename>66931__31327__8fa5c6a5090b4579b60d7fb727868f23.pdf</filename><originalFilename>66931.VoR.pdf</originalFilename><uploaded>2024-09-13T14:09:00.8888325</uploaded><type>Output</type><contentLength>174388</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>This article is Open Access: CC BY 4.0 licence.</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>http://creativecommons.org/licences/by/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling v2 66931 2024-07-03 Recurrent urinary tract infections and prophylactic antibiotic use in women: a cross-sectional study in primary care 0c82f7076d0fc5c916ecbcc472a6a9ae Victoria Best Victoria Best true false aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false 2024-07-03 MEDS Background Despite the considerable morbidity caused by recurrent urinary tract infections (rUTIs), and the wider personal and public health implications from frequent antibiotic use, few studies adequately describe the prevalence and characteristics of women with rUTIs or those who use prophylactic antibiotics.Aim To describe the prevalence, characteristics, and urine profiles of women with rUTIs with and without prophylactic antibiotic use in Welsh primary care.Design and setting This was a retrospective cross-sectional study in Welsh general practice using the Secure Anonymised Information Linkage (SAIL) Databank.Method The characteristics of women aged ≥18 years with rUTIs or using prophylactic antibiotics from 2010 to 2020, and associated urine culture results from 2015 to 2020, are described.Results In total, 6.0% (n = 92 213/N = 1 547 919) had rUTIs, and 1.7% (n = 26 862/N = 1 547 919) were prescribed prophylactic antibiotics with the rates increasing after 57 years of age. Only 49.0% (n =13 149/N = 26 862) of users of prophylactic antibiotics met the definition of rUTIs before initiation. The study found that 80.8% (n = 44 947/N = 55 652) of women with rUTIs had a urine culture result in the preceding 12 months with high rates of resistance to trimethoprim and amoxicillin. Of women taking prophylactic antibiotics, 64.2% (n = 9926/N = 15 455) had a urine culture result before initiation and 18.5% (n = 320/N = 1730) of women prescribed trimethoprim had resistance to it on the antecedent sample.Conclusion A substantial proportion of women had rUTIs or incident prophylactic antibiotic use. However, 64.2% (n = 9926/N = 15 455) of women had urine cultured before starting prophylaxis. There was a high proportion of cultured bacteria resistant to two antibiotics used for rUTI prevention and evidence of resistance to the prescribed antibiotic. More frequent urine cultures for rUTI diagnosis and before prophylactic antibiotic initiation could better inform antibiotic choices. Journal Article British Journal of General Practice 74 746 e619 e627 Royal College of General Practitioners 0960-1643 1478-5242 anti-infective agents; bacterial; drug resistance; electronic health records; primary health care; urinary; urinary tract infections 1 9 2024 2024-09-01 10.3399/bjgp.2024.0015 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University This work was supported by the Welsh Government through Health and Care Research Wales (NIHR-FS-2021-LS to Leigh Sanyaolu). 2024-09-13T14:10:29.9624798 2024-07-03T13:35:18.1233669 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Leigh Sanyaolu 0000-0002-6762-6986 1 Victoria Best 2 Rebecca Cannings-John 3 Fiona Wood 4 Adrian Edwards 5 Ashley Akbari 0000-0003-0814-0801 6 Gail Hayward 7 Haroon Ahmed 8 66931__31327__8fa5c6a5090b4579b60d7fb727868f23.pdf 66931.VoR.pdf 2024-09-13T14:09:00.8888325 Output 174388 application/pdf Version of Record true This article is Open Access: CC BY 4.0 licence. true eng http://creativecommons.org/licences/by/4.0/
title Recurrent urinary tract infections and prophylactic antibiotic use in women: a cross-sectional study in primary care
spellingShingle Recurrent urinary tract infections and prophylactic antibiotic use in women: a cross-sectional study in primary care
Victoria Best
Ashley Akbari
title_short Recurrent urinary tract infections and prophylactic antibiotic use in women: a cross-sectional study in primary care
title_full Recurrent urinary tract infections and prophylactic antibiotic use in women: a cross-sectional study in primary care
title_fullStr Recurrent urinary tract infections and prophylactic antibiotic use in women: a cross-sectional study in primary care
title_full_unstemmed Recurrent urinary tract infections and prophylactic antibiotic use in women: a cross-sectional study in primary care
title_sort Recurrent urinary tract infections and prophylactic antibiotic use in women: a cross-sectional study in primary care
author_id_str_mv 0c82f7076d0fc5c916ecbcc472a6a9ae
aa1b025ec0243f708bb5eb0a93d6fb52
author_id_fullname_str_mv 0c82f7076d0fc5c916ecbcc472a6a9ae_***_Victoria Best
aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari
author Victoria Best
Ashley Akbari
author2 Leigh Sanyaolu
Victoria Best
Rebecca Cannings-John
Fiona Wood
Adrian Edwards
Ashley Akbari
Gail Hayward
Haroon Ahmed
format Journal article
container_title British Journal of General Practice
container_volume 74
container_issue 746
container_start_page e619
publishDate 2024
institution Swansea University
issn 0960-1643
1478-5242
doi_str_mv 10.3399/bjgp.2024.0015
publisher Royal College of General Practitioners
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
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description Background Despite the considerable morbidity caused by recurrent urinary tract infections (rUTIs), and the wider personal and public health implications from frequent antibiotic use, few studies adequately describe the prevalence and characteristics of women with rUTIs or those who use prophylactic antibiotics.Aim To describe the prevalence, characteristics, and urine profiles of women with rUTIs with and without prophylactic antibiotic use in Welsh primary care.Design and setting This was a retrospective cross-sectional study in Welsh general practice using the Secure Anonymised Information Linkage (SAIL) Databank.Method The characteristics of women aged ≥18 years with rUTIs or using prophylactic antibiotics from 2010 to 2020, and associated urine culture results from 2015 to 2020, are described.Results In total, 6.0% (n = 92 213/N = 1 547 919) had rUTIs, and 1.7% (n = 26 862/N = 1 547 919) were prescribed prophylactic antibiotics with the rates increasing after 57 years of age. Only 49.0% (n =13 149/N = 26 862) of users of prophylactic antibiotics met the definition of rUTIs before initiation. The study found that 80.8% (n = 44 947/N = 55 652) of women with rUTIs had a urine culture result in the preceding 12 months with high rates of resistance to trimethoprim and amoxicillin. Of women taking prophylactic antibiotics, 64.2% (n = 9926/N = 15 455) had a urine culture result before initiation and 18.5% (n = 320/N = 1730) of women prescribed trimethoprim had resistance to it on the antecedent sample.Conclusion A substantial proportion of women had rUTIs or incident prophylactic antibiotic use. However, 64.2% (n = 9926/N = 15 455) of women had urine cultured before starting prophylaxis. There was a high proportion of cultured bacteria resistant to two antibiotics used for rUTI prevention and evidence of resistance to the prescribed antibiotic. More frequent urine cultures for rUTI diagnosis and before prophylactic antibiotic initiation could better inform antibiotic choices.
published_date 2024-09-01T14:10:28Z
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