Microbiology testing and antibiotic treatment for urinary tract infections in general practice: a nationwide observational study.

Peng, Z; Hayen, A; Hall, J; Liu, B

Microbiology testing and antibiotic treatment for urinary tract infections in general practice: a nationwide observational study.

Peng, Z Hayen, A

Hall, J Liu, B

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Publisher:: Springer
Publication Type:: Journal Article
Citation:: Infection: journal of infectious disease, 2021, 49, (2), pp. 249-255
Issue Date:: 2021-04

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Field	Value	Language
dc.contributor.author	Peng, Z
dc.contributor.author	Hayen, A https://orcid.org/0000-0003-4046-8030
dc.contributor.author	Hall, J
dc.contributor.author	Liu, B
dc.date.accessioned	2022-01-31T23:11:21Z
dc.date.available	2020-08-20
dc.date.available	2022-01-31T23:11:21Z
dc.date.issued	2021-04
dc.identifier.citation	Infection: journal of infectious disease, 2021, 49, (2), pp. 249-255
dc.identifier.issn	0300-8126
dc.identifier.issn	1439-0973
dc.identifier.uri	http://hdl.handle.net/10453/154007
dc.description.abstract	<h4>Purpose</h4>Routine urine testing is recommended prior to antibiotic treatment for urinary tract infections (UTIs) among high-risk groups for complicated UTIs. This study aims to examine whether the proportion of UTI encounters where antibiotics are prescribed that have accompanying urine testing differs by patient groups.<h4>Methods</h4>A retrospective analysis was conducted using records of general practice encounters for UTIs occurring between January 2013 and July 2018 in an Australian national database. We calculated the proportion of UTI encounters with antibiotics prescribed that had accompanying urine microbiology testing and the odds ratios for the likelihood of testing by patient groups using generalised estimating equations.<h4>Results</h4>Of 132,688 UTI encounters with antibiotics prescribed, 95,800 (72.2%) were accompanied by urine testing. Among high-risk groups for complicated UTIs and expected to have a high likelihood of testing, we found pregnant women [82.6% vs. non-pregnant 72.3%, adjusted odds ratio (aOR) 1.82, 95% confidence intervals (CI) 1.55-2.12] and children aged 5-9 years (77.6% vs. 20-44 years 72.0%, aOR 1.33, 95% CI 1.22-1.45) had relatively high odds of testing. However, children aged < 5 years (68.7% vs. 20-44 years 72.0%, aOR 0.83, 95% CI 0.76-0.90), patients with recurrent UTIs (69.0% compared to first-onset UTIs 73.6%, aOR 0.81, 95% CI 0.79-0.83), and patients in residential aged care facilities (67.3% vs. not 72.3%, aOR 0.80, 95% CI 0.72-0.90) had relatively low odds of testing.<h4>Conclusion</h4>Our results suggest inconsistencies and potential underuse of urine testing when antibiotics were prescribed for high-risk groups in UTI management. Further antibiotic stewardship is needed to improve guideline-based antibiotic prescribing for UTIs.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Springer
dc.relation.ispartof	Infection: journal of infectious disease
dc.relation.isbasedon	10.1007/s15010-020-01512-6
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1103 Clinical Sciences, 1117 Public Health and Health Services
dc.subject.classification	Microbiology
dc.subject.mesh	Anti-Bacterial Agents
dc.subject.mesh	Australia
dc.subject.mesh	Child
dc.subject.mesh	Female
dc.subject.mesh	General Practice
dc.subject.mesh	Humans
dc.subject.mesh	Pregnancy
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Urinary Tract Infections
dc.subject.mesh	Humans
dc.subject.mesh	Urinary Tract Infections
dc.subject.mesh	Anti-Bacterial Agents
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Pregnancy
dc.subject.mesh	Child
dc.subject.mesh	Australia
dc.subject.mesh	Female
dc.subject.mesh	General Practice
dc.title	Microbiology testing and antibiotic treatment for urinary tract infections in general practice: a nationwide observational study.
dc.type	Journal Article
utslib.citation.volume	49
utslib.location.activity	Germany
utslib.for	1103 Clinical Sciences
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	closed_access	*
pubs.consider-herdc	true
dc.date.updated	2022-01-31T23:11:16Z
pubs.issue	2
pubs.publication-status	Published
pubs.volume	49
utslib.citation.issue	2

Abstract:

Purpose

Routine urine testing is recommended prior to antibiotic treatment for urinary tract infections (UTIs) among high-risk groups for complicated UTIs. This study aims to examine whether the proportion of UTI encounters where antibiotics are prescribed that have accompanying urine testing differs by patient groups.

Methods

A retrospective analysis was conducted using records of general practice encounters for UTIs occurring between January 2013 and July 2018 in an Australian national database. We calculated the proportion of UTI encounters with antibiotics prescribed that had accompanying urine microbiology testing and the odds ratios for the likelihood of testing by patient groups using generalised estimating equations.

Results

Of 132,688 UTI encounters with antibiotics prescribed, 95,800 (72.2%) were accompanied by urine testing. Among high-risk groups for complicated UTIs and expected to have a high likelihood of testing, we found pregnant women [82.6% vs. non-pregnant 72.3%, adjusted odds ratio (aOR) 1.82, 95% confidence intervals (CI) 1.55-2.12] and children aged 5-9 years (77.6% vs. 20-44 years 72.0%, aOR 1.33, 95% CI 1.22-1.45) had relatively high odds of testing. However, children aged < 5 years (68.7% vs. 20-44 years 72.0%, aOR 0.83, 95% CI 0.76-0.90), patients with recurrent UTIs (69.0% compared to first-onset UTIs 73.6%, aOR 0.81, 95% CI 0.79-0.83), and patients in residential aged care facilities (67.3% vs. not 72.3%, aOR 0.80, 95% CI 0.72-0.90) had relatively low odds of testing.

Conclusion

Our results suggest inconsistencies and potential underuse of urine testing when antibiotics were prescribed for high-risk groups in UTI management. Further antibiotic stewardship is needed to improve guideline-based antibiotic prescribing for UTIs.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/154007