Antibiotic duration for treating uncomplicated, symptomatic lower urinary tract infections in elderly women

Lutters, Monika; Vogt-ferrier, Nicole Barbara

doi:10.1002/14651858.cd001535.pub2

Cited by 78 publications

(41 citation statements)

References 144 publications

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“…There have also been other studies which show the high drug resistance of P. aeruginosa in Nigeria 19 (Table 4) as well as showing the most rapid rise in resistance (Table 3). This does not undermine E. coli as the most prevalent bacteria in UTI as earlier reported by Orenstein and Wong 28 and Lutters and colleagues, 29 who reported that the UTI may be endogenous or exogenous. S. aureus was the most prevalent Grampositive bacteria isolated with a mean percentage of 10.1% ( Table 2).…”

Section: Discussionsupporting

confidence: 69%

Increasing resistance to quinolones: A four-year prospective study of urinary tract infection pathogens

Omigie

Okoror²,

Umolu³

et al. 2009

IJGM

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Abstract:A four-year prospective study was carried out to determine the incidence and rate of development of resistance by common urinary tract infection (UTI) pathogens to quinolone antimicrobial agents. Results show that there is high intrinsic resistance to the quinolones among strains of Pseudomonas aeruginosa (43.4%), Escherichia coli (26.3%), and Proteus spp. (17.1%). Over four years, rising rates of resistance were observed in P. aeruginosa (14.6% increase), Staphylococcus aureus (9.8%), and E. coli (9.7%). The highest potency was exhibited by ciprofloxacin (91.2%), levofloxacin (89.2%), and moxifloxacin (85.1%), while there were high rates of resistance to nalidixic acid (51.7%) and pefloxacin (29.0%). Coliforms, particularly E. coli (45%), remain the most prevalent causative agents of UTI while females within the age range of 20-50 years were most vulnerable to UTI.

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Section: Discussionsupporting

confidence: 69%

Increasing resistance to quinolones: A four-year prospective study of urinary tract infection pathogens

Omigie

Okoror²,

Umolu³

et al. 2009

IJGM

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“…4 A recently updated Cochrane review now recommends that short-term (3-to 6-day) treatment of uncomplicated UTIs in older women is as effective as long-term treatment (7 to 14 days). 6 Comparing the efficacy of short versus longer duration antibiotic treatment was not an objective of this study and therefore we can make no specific recommendations on this subject.…”

Section: Discussionmentioning

confidence: 98%

Urinary Tract Infection in Women Over the Age of 65: Is Age Alone a Marker of Complication?

Grover¹,

Bracamonte²,

Kanodia³

et al. 2009

The Journal of the American Board of Family Medicine

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Background:We were interested to know if our older female patients with urinary tract infections (UTIs) might have differing pathogens or rates of Escherichia coli antibiotic sensitivity and if our physicians managed them in a manner similar or dissimilar to the care provided to younger patients with no complications.Methods: This was a secondary analysis from patients excluded from a previous retrospective study regarding uncomplicated UTIs.Results: Twenty-six percent of total patients with UTIs were older than 65 and otherwise medically uncomplicated whereas 21% were older patients who did have complicating factors. E. coli was a pathogen in 81% of uncomplicated elders' and 54% of complicated elders' cultures. E. coli sensitivity rate to sulfamethoxazole-trimethoprim (SMX/TMP) in both groups was 86%. Physicians were significantly less likely to prescribe SMX/TMP for complicated older patients with complications than for young patients with an uncomplicated UTI (P ‫؍‬ .017); there was a significant trend of physicians to be less likely to prescribe SMX/TMP with advancing age in a patient and complications across all 3 groups (P ‫؍‬ .011). Antibiotics rarely needed to be changed after cultures.Conclusions: The presence of E. coli on culture in patients with a UTI changes based on medical complications, not age. Being medically complex did not result in reduced sensitivity of E. coli to SMX/ TMP but was associated with increased rates of the presence of other pathogens. In our setting, treatment employed with SMX/TMP and without the use of culture and sensitivity may be effective for appropriately selected older women. Prospective studies are needed to determine the optimal approach to management.

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“…However, a Cochrane Review found no reduction in satisfaction for short courses of antibiotics in urinary tract infections. 21 In a study of almost 7000 Swedish patients registered at 39 practices, those registered at practices with higher antibiotic prescribing rates (antibiotic prescribing volume per GP consultation) were more satisfied, whereas this was partially offset by lower antibiotic prescribing in practices where the GP spent more time listening to the patient. 4 The current study's findings differed and the GP characteristic of 'listening' was not associated with lower antibiotic prescribing.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Antibiotic prescribing and patient satisfaction in primary care in England: cross-sectional analysis of national patient survey data and prescribing data

et al. 2015

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BackgroundConcerns about adverse effects on patient satisfaction may be an important obstacle to attempts to curtail antibiotic prescribing. AimTo determine the relationship between antibiotic prescribing in general practice and reported patient satisfaction. Design and settingRetrospective cross-sectional study of general practices in England. Method ResultsThe final dataset consisted of 7800 (95.5%) practices. A total of 33.7 million antibiotic prescriptions were issued to a registered population of 53.8 million patients. Antibiotic prescribing volume was a significant positive predictor of all 'doctor satisfaction' and 'practice satisfaction' scores in the GPPS, and was the strongest predictor of overall satisfaction out of 13 prescribing variables. A theoretical 25% reduction in antibiotic prescribing volume would be associated with 0.5-1.0% lower patient satisfaction scores, a drop of 3-6 centile points in national satisfaction ranking. ConclusionPatients were less satisfied in practices with frugal antibiotic prescribing. A cautious approach to antibiotic prescribing may require a trade-off in terms of patient satisfaction.

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Antibiotic duration for treating uncomplicated, symptomatic lower urinary tract infections in elderly women

Abstract: Cochrane Database of Systematic Reviews

Cited by 78 publications

References 144 publications

Increasing resistance to quinolones: A four-year prospective study of urinary tract infection pathogens

Increasing resistance to quinolones: A four-year prospective study of urinary tract infection pathogens

Urinary Tract Infection in Women Over the Age of 65: Is Age Alone a Marker of Complication?

Antibiotic prescribing and patient satisfaction in primary care in England: cross-sectional analysis of national patient survey data and prescribing data

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