1449. Antibiotic Choice, Duration, and Outcome in Community-Acquired Urinary Tract Infections (UTI) in Male Patients

Abstract

BackgroundIt is common medical practice for all urinary tract infections (UTIs) in males to be diagnosed as “complicated” UTIs. Current guidelines recommend 7 to 14 days of antibiotics for complicated UTIs. Longer duration of antibiotics potentially exposes a patient to harm without sufficient evidence for benefit. This research will attempt to determine the optimal antibiotic and duration of treatment for males diagnosed with a UTI.MethodsThis study is a retrospective cohort study that utilized the electronic health record for Kaiser Permanente Southern California to search for male patients with a diagnosis of cystitis or UTI in the outpatient setting from 2011 to 2016. Only patients with confirmed bacteriuria >100,000 CFU/mL of a gram-negative organism were included. Exclusion criteria included Foley catheterization, intermittent self-catheterization, prostatitis and Pseudomonas infection. There were 10,662 patients in our database who fit these criteria, but only 134 patients were reviewed for preliminary analysis for this abstract. Outcomes included recurrence of UTI within 30 days of finishing treatmentResultsA total of 134 patients were included. Most patients were prescribed Ciprofloxacin (69%) or Cephalexin (19%). The prescription duration was >8 days for 52%, 7–8 days for 34% and <7 days for 14% of all the patients. There was a statistically significant difference in recurrence by antibiotic duration (Figure 1). The odds of recurrence were 3.9 times higher for people with <7 days prescription compared with those with > 8 days (95% CI, 1.28–11.89, P = .017) (Table 1). The odds of recurrence were 1.5 times higher for those with a prescription of 7–8 days compared with those with a prescription of > 8 days, but the difference was not statistically significant (95% CI: 0.59, 3.7, P = .38).ConclusionMale patients diagnosed with a UTI who were treated with a course of antibiotics for > 7 days were less likely to have a UTI recurrence than patients who were treated for < 7 days. However, there was no statistically significant difference between 7 to 8 days vs. >8 days of antibiotics in terms of recurrence. This study will be continued to increase study power. Determining the best treatment course will reduce healthcare cost and patient morbidity from UTI recurrences. Disclosures All authors: No reported disclosures.