Short-course intravenous beta-lactams for uncomplicated cystitis in hospitalized patients
Abstract Purpose: Currently, the Infectious Diseases Society of America (IDSA) Guidelines for Uncomplicated Urinary Tract Infections (UTIs) recommend a 3 to 7-day antibiotic course of oral beta-lactam agents when other recommended agents are not feasible. In recent years, studies have demonstrated...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Cambridge University Press
2025-01-01
|
| Series: | Antimicrobial Stewardship & Healthcare Epidemiology |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2732494X25101010/type/journal_article |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849229157374885888 |
|---|---|
| author | Payton Simpson Katie Wallace Katherine Olney Danielle Casaus David S. Burgess Aric Schadler Abigail Leonhard Jeremy VanHoose |
| author_facet | Payton Simpson Katie Wallace Katherine Olney Danielle Casaus David S. Burgess Aric Schadler Abigail Leonhard Jeremy VanHoose |
| author_sort | Payton Simpson |
| collection | DOAJ |
| description |
Abstract
Purpose:
Currently, the Infectious Diseases Society of America (IDSA) Guidelines for Uncomplicated Urinary Tract Infections (UTIs) recommend a 3 to 7-day antibiotic course of oral beta-lactam agents when other recommended agents are not feasible. In recent years, studies have demonstrated efficacy in shorter courses of antimicrobial therapy for acute uncomplicated cystitis compared with longer courses, but there is limited data regarding intravenous beta-lactams for acute uncomplicated cystitis.
Methods:
This single-center, retrospective, non-inferiority cohort study included adult patients admitted to University of Kentucky Albert B. Chandler Medical Center or Good Samaritan Hospital with acute uncomplicated cystitis. The primary outcome assessed was treatment failure, defined as the need for retreatment with additional antibiotic therapy within 30 days of antibiotic completion. Secondary outcomes include incidence of C. difficile infection within 30 days of antibiotic therapy, hospital readmission, and outpatient telephone encounters within 30 days of discharge. Patients were divided into the short course (those receiving three days or less of beta-lactam antibiotics and at least 1 day was IV) or the long course (those receiving four or more days of beta lactam antibiotics).
Results:
Overall, 52 patients met the criteria to be included in the final study, with 33 in the short course beta-lactam group and 19 in the long-course beta-lactam group. Failure rates between short and long course were 15.2% and 15.8% respectively (p=1.000). Ceftriaxone was the most commonly utilized antibiotic in both groups. The median total antibiotic duration between the long and short groups was 3 and 6 days respectively (p<0.001).
Conclusions:
In hospitalized patients warranting initial IV therapy for acute uncomplicated cystitis, a 3-day total of beta-lactam therapy, with transition to oral, should be considered.
|
| format | Article |
| id | doaj-art-491697d2e75a4c408da2a95903fb384a |
| institution | Kabale University |
| issn | 2732-494X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Antimicrobial Stewardship & Healthcare Epidemiology |
| spelling | doaj-art-491697d2e75a4c408da2a95903fb384a2025-08-22T05:32:08ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2025-01-01510.1017/ash.2025.10101Short-course intravenous beta-lactams for uncomplicated cystitis in hospitalized patientsPayton Simpson0https://orcid.org/0009-0004-4813-9703Katie Wallace1https://orcid.org/0000-0002-9718-8067Katherine Olney2https://orcid.org/0000-0001-7536-9070Danielle Casaus3David S. Burgess4Aric Schadler5https://orcid.org/0000-0001-8814-5834Abigail Leonhard6Jeremy VanHoose7Department of Pharmacy Services, University of Kentucky HealthCare, Lexington, KY, USADepartment of Pharmacy Services, University of Kentucky HealthCare, Lexington, KY, USA Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, KY, USADepartment of Pharmacy Services, University of Kentucky HealthCare, Lexington, KY, USA Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, KY, USADepartment of Pharmacy Services, University of Kentucky HealthCare, Lexington, KY, USADepartment of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, KY, USAUniversity of Kentucky Pharmacy and University of Kentucky HealthCare Pediatrics, Lexington, KY, USADr. Bing Zhang Department of Statistics, College of Arts and Science, University of Kentucky, Lexington, KY, USADepartment of Pharmacy Services, University of Kentucky HealthCare, Lexington, KY, USA Abstract Purpose: Currently, the Infectious Diseases Society of America (IDSA) Guidelines for Uncomplicated Urinary Tract Infections (UTIs) recommend a 3 to 7-day antibiotic course of oral beta-lactam agents when other recommended agents are not feasible. In recent years, studies have demonstrated efficacy in shorter courses of antimicrobial therapy for acute uncomplicated cystitis compared with longer courses, but there is limited data regarding intravenous beta-lactams for acute uncomplicated cystitis. Methods: This single-center, retrospective, non-inferiority cohort study included adult patients admitted to University of Kentucky Albert B. Chandler Medical Center or Good Samaritan Hospital with acute uncomplicated cystitis. The primary outcome assessed was treatment failure, defined as the need for retreatment with additional antibiotic therapy within 30 days of antibiotic completion. Secondary outcomes include incidence of C. difficile infection within 30 days of antibiotic therapy, hospital readmission, and outpatient telephone encounters within 30 days of discharge. Patients were divided into the short course (those receiving three days or less of beta-lactam antibiotics and at least 1 day was IV) or the long course (those receiving four or more days of beta lactam antibiotics). Results: Overall, 52 patients met the criteria to be included in the final study, with 33 in the short course beta-lactam group and 19 in the long-course beta-lactam group. Failure rates between short and long course were 15.2% and 15.8% respectively (p=1.000). Ceftriaxone was the most commonly utilized antibiotic in both groups. The median total antibiotic duration between the long and short groups was 3 and 6 days respectively (p<0.001). Conclusions: In hospitalized patients warranting initial IV therapy for acute uncomplicated cystitis, a 3-day total of beta-lactam therapy, with transition to oral, should be considered. https://www.cambridge.org/core/product/identifier/S2732494X25101010/type/journal_article |
| spellingShingle | Payton Simpson Katie Wallace Katherine Olney Danielle Casaus David S. Burgess Aric Schadler Abigail Leonhard Jeremy VanHoose Short-course intravenous beta-lactams for uncomplicated cystitis in hospitalized patients Antimicrobial Stewardship & Healthcare Epidemiology |
| title | Short-course intravenous beta-lactams for uncomplicated cystitis in hospitalized patients |
| title_full | Short-course intravenous beta-lactams for uncomplicated cystitis in hospitalized patients |
| title_fullStr | Short-course intravenous beta-lactams for uncomplicated cystitis in hospitalized patients |
| title_full_unstemmed | Short-course intravenous beta-lactams for uncomplicated cystitis in hospitalized patients |
| title_short | Short-course intravenous beta-lactams for uncomplicated cystitis in hospitalized patients |
| title_sort | short course intravenous beta lactams for uncomplicated cystitis in hospitalized patients |
| url | https://www.cambridge.org/core/product/identifier/S2732494X25101010/type/journal_article |
| work_keys_str_mv | AT paytonsimpson shortcourseintravenousbetalactamsforuncomplicatedcystitisinhospitalizedpatients AT katiewallace shortcourseintravenousbetalactamsforuncomplicatedcystitisinhospitalizedpatients AT katherineolney shortcourseintravenousbetalactamsforuncomplicatedcystitisinhospitalizedpatients AT daniellecasaus shortcourseintravenousbetalactamsforuncomplicatedcystitisinhospitalizedpatients AT davidsburgess shortcourseintravenousbetalactamsforuncomplicatedcystitisinhospitalizedpatients AT aricschadler shortcourseintravenousbetalactamsforuncomplicatedcystitisinhospitalizedpatients AT abigailleonhard shortcourseintravenousbetalactamsforuncomplicatedcystitisinhospitalizedpatients AT jeremyvanhoose shortcourseintravenousbetalactamsforuncomplicatedcystitisinhospitalizedpatients |