Treatment patterns and burden of uncomplicated urinary tract infection in England: a retrospective cohort study.
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All Authors
Wilcox, MH.
Heaton, D.
Mulgirigama, A.
Joshi, AV.
Chirikov, V.
Gibbons, DC.
Webb, D.
Marston, XL.
Alexander, MN.
Mitrani-Gold, FS.
LTHT Author
Wilcox, Mark
LTHT Department
Microbiology
Non Medic
Publication Date
2025
Item Type
Journal Article
Language
Subject
Subject Headings
Abstract
BACKGROUND: Uncomplicated urinary tract infections (uUTIs) are common bacterial infections.
AIM: To evaluate the burden of uUTI in England for 1) potential determinants of disease progression; 2) extent and impact of antimicrobial prescribing non-concordant with treatment guidelines; and 3) healthcare burden and economic costs.
DESIGN & SETTING: Retrospective cohort study utilising patient data (January 2017-February 2020) from the Clinical Practice Research Datalink (CPRD) linked to English Hospital Episode Statistics.
METHOD: Female patients aged >=12 years with a new uUTI between 2018 and 2019, >=14 months' continuous CPRD enrolment (>=12 months baseline, >=2 months follow-up), and >=1 oral antibiotic prescription +/-5 days of uUTI diagnosis were included. Baseline characteristics were described in patients with or without disease progression (hospitalisation for acute pyelonephritis, bacteraemia, or sepsis). Treatment non-concordance with current English guidelines was assessed. Burden (all-cause and urinary tract infection-related healthcare resource use [HCRU] and costs) was evaluated in a 1:1 age and comorbidity-matched uUTI-free cohort.
RESULTS: Of 120 519 patients, 207 (0.2%) had disease progression requiring hospitalisation (during index uUTI episode); determinants included older age, index uUTI home consultation, prior hospitalisation, and medications prescribed for comorbid conditions in the prior 12 months (British National Formulary classes: cardiovascular system, eye, and other drugs and preparations). Non-concordant treatment was observed in 43.5% of patients. All-cause HCRU burden and costs were significantly higher in patients with uUTI versus age and comorbidity-matched controls (P<0.001) at 28 days (160.06 versus 37.63) and in the 12-month follow-up (1206.77 versus 460.97).
CONCLUSION: All-cause HCRU burden and costs were significantly higher in patients with uUTI versus matched controls (P<0.001). Hospitalisation for acute pyelonephritis, bacteraemia, or sepsis following uUTI was uncommon.
Journal
Bjgp Open