Predicting the use of antibiotics after initial symptomatic treatment of an uncomplicated urinary tract infection: analyses performed after a randomised controlled trial
Objective To predict antibiotic use after initial treatment with ibuprofen using data from a randomised controlled trial comparing ibuprofen to pivmecillinam in the treatment of women with symptoms of an uncomplicated urinary tract infection (UTI).Setting 16 sites in a primary care setting in Norway...
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BMJ Publishing Group
2020-08-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/8/e035074.full |
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| author | Ibrahimu Mdala Morten Lindbaek Ingvild Vik Marianne Bollestad Gloria Cristina Cordoba Lars Bjerrum Thomas Neumark Eivind Damsgaard Anders Bærheim Nils Grude |
| author_facet | Ibrahimu Mdala Morten Lindbaek Ingvild Vik Marianne Bollestad Gloria Cristina Cordoba Lars Bjerrum Thomas Neumark Eivind Damsgaard Anders Bærheim Nils Grude |
| author_sort | Ibrahimu Mdala |
| collection | DOAJ |
| description | Objective To predict antibiotic use after initial treatment with ibuprofen using data from a randomised controlled trial comparing ibuprofen to pivmecillinam in the treatment of women with symptoms of an uncomplicated urinary tract infection (UTI).Setting 16 sites in a primary care setting in Norway, Sweden and Denmark.Participants Data from 181 non-pregnant women aged 18–60 presenting with symptoms of uncomplicated UTI, initially treated with ibuprofen.Methods Using the least absolute shrinkage and selection operator logistic regression model, we conducted analyses to see if baseline information could help us predict which women could be treated with ibuprofen without risking treatment failure and which women should be recommended antibiotics.Results Of the 143 women included in the final analysis, 77 (53.8%) recovered without antibiotics and 66 (46.2 %) were subsequently prescribed antibiotics. In the unadjusted binary logistic regression, the number of days with symptoms before inclusion (<3 days) and feeling moderately unwell or worse (≥4 on a scale of 0–6) were significant predictors for subsequent antibiotic use. In the adjusted model, no predictors were significantly associated with subsequent antibiotic use. The area under the curve of the final model was 0.66 (95% CI: 0.57 to 0.74).Conclusion We did not find any baseline information that significantly predicted the use of antibiotic treatment. Identifying women who need antibiotic treatment to manage their uncomplicated UTI is still challenging. Larger data sets are needed to develop models that are more accurate.Trial registration number ClinicalTrials.gov (NCT01849926). |
| format | Article |
| id | doaj-art-33cec24cd7254231ad77508f79f449c3 |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-08-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-33cec24cd7254231ad77508f79f449c32025-08-20T02:51:19ZengBMJ Publishing GroupBMJ Open2044-60552020-08-0110810.1136/bmjopen-2019-035074Predicting the use of antibiotics after initial symptomatic treatment of an uncomplicated urinary tract infection: analyses performed after a randomised controlled trialIbrahimu Mdala0Morten Lindbaek1Ingvild Vik2Marianne Bollestad3Gloria Cristina Cordoba4Lars Bjerrum5Thomas Neumark6Eivind Damsgaard7Anders Bærheim8Nils Grude9Department of General Practice, University of Oslo, Oslo, NorwayDepartment of General Practice, Institute of Health and Society, University of Oslo, Oslo, NorwayDepartment of Emergency General Practice, City of Oslo Health Agency, Oslo Accident and Emergency Outpatient Clinic, Oslo, NorwayDepartment of General Practice, Antibiotic Centre for Primary Care, Institute of Health and Society, University of Oslo, Oslo, NorwayPhD fellowDepartment of Public Health, University of Copenhagen, Copenhagen, DenmarkPrimary Health Care and Planning Division, Kalmar County Council, Kalmar, SwedenBergen Accident and Emergency Department, Bergen Kommune, Bergen, NorwayDepartment of Global Public Health and Primary Care, University of Bergen, Bergen, Hordaland, NorwayAntibiotic Centre for Primary Care, Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, NorwayObjective To predict antibiotic use after initial treatment with ibuprofen using data from a randomised controlled trial comparing ibuprofen to pivmecillinam in the treatment of women with symptoms of an uncomplicated urinary tract infection (UTI).Setting 16 sites in a primary care setting in Norway, Sweden and Denmark.Participants Data from 181 non-pregnant women aged 18–60 presenting with symptoms of uncomplicated UTI, initially treated with ibuprofen.Methods Using the least absolute shrinkage and selection operator logistic regression model, we conducted analyses to see if baseline information could help us predict which women could be treated with ibuprofen without risking treatment failure and which women should be recommended antibiotics.Results Of the 143 women included in the final analysis, 77 (53.8%) recovered without antibiotics and 66 (46.2 %) were subsequently prescribed antibiotics. In the unadjusted binary logistic regression, the number of days with symptoms before inclusion (<3 days) and feeling moderately unwell or worse (≥4 on a scale of 0–6) were significant predictors for subsequent antibiotic use. In the adjusted model, no predictors were significantly associated with subsequent antibiotic use. The area under the curve of the final model was 0.66 (95% CI: 0.57 to 0.74).Conclusion We did not find any baseline information that significantly predicted the use of antibiotic treatment. Identifying women who need antibiotic treatment to manage their uncomplicated UTI is still challenging. Larger data sets are needed to develop models that are more accurate.Trial registration number ClinicalTrials.gov (NCT01849926).https://bmjopen.bmj.com/content/10/8/e035074.full |
| spellingShingle | Ibrahimu Mdala Morten Lindbaek Ingvild Vik Marianne Bollestad Gloria Cristina Cordoba Lars Bjerrum Thomas Neumark Eivind Damsgaard Anders Bærheim Nils Grude Predicting the use of antibiotics after initial symptomatic treatment of an uncomplicated urinary tract infection: analyses performed after a randomised controlled trial BMJ Open |
| title | Predicting the use of antibiotics after initial symptomatic treatment of an uncomplicated urinary tract infection: analyses performed after a randomised controlled trial |
| title_full | Predicting the use of antibiotics after initial symptomatic treatment of an uncomplicated urinary tract infection: analyses performed after a randomised controlled trial |
| title_fullStr | Predicting the use of antibiotics after initial symptomatic treatment of an uncomplicated urinary tract infection: analyses performed after a randomised controlled trial |
| title_full_unstemmed | Predicting the use of antibiotics after initial symptomatic treatment of an uncomplicated urinary tract infection: analyses performed after a randomised controlled trial |
| title_short | Predicting the use of antibiotics after initial symptomatic treatment of an uncomplicated urinary tract infection: analyses performed after a randomised controlled trial |
| title_sort | predicting the use of antibiotics after initial symptomatic treatment of an uncomplicated urinary tract infection analyses performed after a randomised controlled trial |
| url | https://bmjopen.bmj.com/content/10/8/e035074.full |
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