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...

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Autores principales:	Romain Martischang, Maciek Godycki-Ćwirko, Anna Kowalczyk, Katarzyna Kosiek, Adi Turjeman, Tanya Babich, Shachaf Shiber, Leonard Leibovici, Elodie von Dach, Stephan Harbarth, Angela Huttner
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/5b1ac2ce7ec7499ca1f81860f6206a7c
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spelling	oai:doaj.org-article:5b1ac2ce7ec7499ca1f81860f6206a7c2021-12-02T20:19:20ZRisk factors for treatment failure in women with uncomplicated lower urinary tract infection.1932-620310.1371/journal.pone.0256464https://doaj.org/article/5b1ac2ce7ec7499ca1f81860f6206a7c2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0256464https://doaj.org/toc/1932-6203Given 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.Romain MartischangMaciek Godycki-ĆwirkoAnna KowalczykKatarzyna KosiekAdi TurjemanTanya BabichShachaf ShiberLeonard LeiboviciElodie von DachStephan HarbarthAngela HuttnerPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0256464 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q 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.
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.
format	article
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
title	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_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_sort	risk factors for treatment failure in women with uncomplicated lower urinary tract infection.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/5b1ac2ce7ec7499ca1f81860f6206a7c
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Risk factors for treatment failure in women with uncomplicated lower urinary tract infection.

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