The Effect of Sociodemographic Factors, Parity and Cervical Cancer on Antibiotic Treatment for Uncomplicated Cystitis in Women: A Nationwide Cohort Study.

Filip Jansåker,Jenny Dahl Knudsen,Veronica Milos Nymberg,Kristina Sundquist,Xinjun Li

doi:10.3390/antibiotics10111389

Abstract

Background: Uncomplicated cystitis is one of the most common reasons for antibiotic treatment in otherwise healthy women. Nationwide studies on antibiotic treatment for this infection and in relation to factors beyond the infection itself have hitherto not been available. Methods: This was a nationwide open cohort study consisting of 352,507 women aged 15–50 years with uncomplicated cystitis (2006–2018). The outcome was a redeemed antibiotic prescription within five days from the cystitis diagnosis. Logistic regression models were used to examine the relationship between the outcome and the predictor variables. Results: This study identified 192,065 redeemed treatments (54.5%). Several sociodemographic variables were associated with antibiotic treatment. For example, women with the lowest income had an odds ratio (OR) of 1.26 (95% CI 1.23–1.28) compared to those with the highest income. History of cervical cancer and high parity were also associated with lower treatment rates. Conclusion: This study presents novel factors beyond the infection which seem to affect the antibiotic treatment for uncomplicated cystitis in women. Future studies to investigate possible mechanisms are warranted in order to properly use our findings. This may help healthcare workers and planners to provide a more equal treatment plan for this common infection, which may reduce misuse of antibiotics, decrease costs and improve efforts against antibiotic resistance.

Highlights

The worldwide increase in antibiotic consumption and resistance is of great concern [1].Several strategies have been suggested on how to minimize the misuse and overuse of antibiotics in order to avoid increasing antibiotic resistance in society [2,3,4]
Treatment rates varied between 46.5% in women living in northern Sweden and 61.5% in women originating from Asia and Oceania
This study found that antibiotic treatment rates for uncomplicated cystitis varied amongst different sociodemographic groups of women

Summary

Introduction

The worldwide increase in antibiotic consumption and resistance is of great concern [1].Several strategies have been suggested on how to minimize the misuse and overuse of antibiotics in order to avoid increasing antibiotic resistance in society [2,3,4]. Uncomplicated cystitis, known as uncomplicated lower UTI, is one of the most common infections in otherwise healthy women [6,7,8,9] These infections are generally caused by the overgrowth of bacteria in the urinary tract, mainly Escherichia coli followed by Staphylococcus saprophyticus, and are often effectively treated with a short duration of antibiotic therapy [10,11,12,13,14,15]. Future studies to investigate possible mechanisms are warranted in order to properly use our findings This may help healthcare workers and planners to provide a more equal treatment plan for this common infection, which may reduce misuse of antibiotics, decrease costs and improve efforts against antibiotic resistance

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Discussion

Conclusion