MP25-14 FACTORS ASSOCIATED WITH ADVERSE SHORT-TERM HEALTH OUTCOMES AMONG FEMALE OUTPATIENTS WITH UNCOMPLICATED URINARY TRACT INFECTION

Abstract

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Kidney & Bladder I (MP25)1 Sep 2021MP25-14 FACTORS ASSOCIATED WITH ADVERSE SHORT-TERM HEALTH OUTCOMES AMONG FEMALE OUTPATIENTS WITH UNCOMPLICATED URINARY TRACT INFECTION Keith S. Kaye, Vikas Gupta, Aruni Mulgirigama, Barbara W. Trautner, Fanny S. Mitrani-Gold, Nicole E. Scangarella-Oman, Kalvin Yu, Gang Ye, and Ashish V. Joshi Keith S. KayeKeith S. Kaye More articles by this author , Vikas GuptaVikas Gupta More articles by this author , Aruni MulgirigamaAruni Mulgirigama More articles by this author , Barbara W. TrautnerBarbara W. Trautner More articles by this author , Fanny S. Mitrani-GoldFanny S. Mitrani-Gold More articles by this author , Nicole E. Scangarella-OmanNicole E. Scangarella-Oman More articles by this author , Kalvin YuKalvin Yu More articles by this author , Gang YeGang Ye More articles by this author , and Ashish V. JoshiAshish V. Joshi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002022.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Short-term (28-day) health outcomes in females with uncomplicated urinary tract infection (uUTI) were assessed to determine if uropathogen infection not covered by initial therapy was associated with adverse outcomes. METHODS: This was a retrospective study of uUTI episodes (culture-positive with antimicrobial prescription ±1 day from initial urine culture [index]) among female outpatients (aged ≥12 years), across 9 US facilities (2016–2019; BD Insights Research Database). Exclusion criteria were: immunosuppression, pregnancy, severe renal impairment, uncontrolled diabetes. Enterobacterales and Staphylococcus saprophyticus isolates were evaluated as susceptible or not-susceptible (NS, intermediate/resistant) to initial antimicrobial prescribed. Health outcomes evaluated were: new antimicrobial prescription, all-cause hospitalizations, all-cause outpatient emergency department/clinic visits. Multivariable modeling assessment of health outcomes was conducted using generalized linear mixed models. RESULTS: Of 2366 index uUTI episodes from 2087 females (mean age [range], 48 [12–90] years), 80.6% had isolates susceptible and 19.4% NS to initial antimicrobial; Escherichia coli was isolated in 78.5% of all episodes. Within 28 days post-index, episodes with isolates NS to initial antimicrobial were more likely to have new antimicrobial prescriptions and subsequent hospitalization than those with susceptible isolates (29.0% vs 18.1%; p<0.001 and 10.3% vs 6.3%; p=0.012, respectively). After covariate adjustment, episodes with pathogens NS to initial antimicrobial prescription were significantly more likely to have new antimicrobial prescriptions within 28 days than those with susceptible pathogens (odds ratio [95% confidence interval], 1.6 [1.3–2.1]). See Table for independent predictors of health outcomes. CONCLUSIONS: Initial antimicrobial prescription that does not cover the index uUTI isolate and baseline patient-level factors such as age, prior resistance, antimicrobial treatment, and hospitalization were associated with adverse short-term health outcomes. These findings can support antimicrobial stewardship efforts to improve antibiotic prescribing and related outcomes in outpatients with urinary tract infections. Source of Funding: GlaxoSmithKline plc.-sponsored study © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e458-e459 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Keith S. Kaye More articles by this author Vikas Gupta More articles by this author Aruni Mulgirigama More articles by this author Barbara W. Trautner More articles by this author Fanny S. Mitrani-Gold More articles by this author Nicole E. Scangarella-Oman More articles by this author Kalvin Yu More articles by this author Gang Ye More articles by this author Ashish V. Joshi More articles by this author Expand All Advertisement Loading ...