Abstract
BackgroundUrinary tract infections (UTIs) are among the most common bacterial infections. Despite this burden, there are few studies of the costs of UTIs. The objective of this study was to determine the costs of UTIs in women over 18 years of age who visit general practitioners in France.MethodsThe direct and indirect costs of clinical UTIs were estimated from societal, French National Health Insurance and patient perspectives. The study population was derived from a national cross-sectional survey entitled the Drug-Resistant Urinary Tract Infection (Druti). The Druti included every woman over 18 years of age who presented with symptoms of UTI and was conducted in France in 2012 and 2013 to estimate the annual incidence of UTIs due to antibiotic-resistant Enterobacteriaceae in women visiting general practitioners (GPs) for suspected UTIs.ResultsOf the 538 women included in Druti, 460 were followed over 8 weeks and included in the cost analysis. The mean age of the women was 46 years old. The median cost of care for one episode of a suspected UTI was €38, and the mean cost was €70. The annual societal cost was €58 million, and €29 million of this was reimbursed by the French National Health Insurance system. In 25 % of the cases, the suspected UTIs were associated with negative urine cultures. The societal cost of these suspected UTIs with negative urine cultures was €13.5 million. No significant difference was found between the costs of the UTIs due to antibiotic-resistant E. coli and those due to wild E. coli (p = 0.63).ConclusionIn the current context in which the care costs are continually increasing, the results of this study suggests that it is possible to decrease the cost of UTIs by reducing the costs of suspected UTIs and unnecessary treatments, as well as limiting the use of non-recommended tests.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1620-2) contains supplementary material, which is available to authorized users.
Highlights
Urinary tract infections (UTIs) are among the most common bacterial infections
Population and urine cultures During the study, 87 general practitioners (GP) enrolled 1,569 women who visited with symptoms of UTI
€ euros aamoxicillin, amoxicillin – clavulanic acid, cefixime, cefpodoxime, ceftriaxone, ciproloxacine, enoxacine, lomefloxacin, nirofurantoin, norfloxacin, nystatin, oxfloxacin, pefloxacin, nalidixic acid, trimethoprim-sulphamethoxazole bAntifungals, digestive transit regulators, hormonal treatments, proton pump inhibitors with non-steroidal anti-inflammatory drugs and corticosteroids cEstimated proportion or mean cost with the sampling design dNo 95 % confidence interval (CI) due to exact cost. This initial study conducted in France on the costs of community UTIs in women over 18 years of age estimated a total cost from the societal perspective of €58 million in 2012, €44 million for direct costs and €14 million for indirect costs
Summary
Urinary tract infections (UTIs) are among the most common bacterial infections. Despite this burden, there are few studies of the costs of UTIs. The objective of this study was to determine the costs of UTIs in women over 18 years of age who visit general practitioners in France. Urinary tract infections (UTIs) are among the most common bacterial infections [1] and affect nearly half of all women at least once in their lives [2]. The main objective of this study was to calculate the direct and indirect UTI costs (including cystitis and acute pyelonephritis) in women over 18 years of age who visit general practices in France. The secondary objectives were to calculate the costs of suspected UTIs with negative urine cultures and to compare the costs of UTIs due to antibioticresistant E. coli with those of UTIs due to wild E. coli
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