The Risk of Pyelonephritis Following Uncomplicated Cystitis : A Nationwide Primary Healthcare Study
(2022) In Antibiotics 11(12).- Abstract
Background: The risk of pyelonephritis following uncomplicated lower urinary tract infection (cystitis) in women has not been studied in well-powered samples. This is likely due to the previous lack of nationwide primary healthcare data. We aimed to examine the risks of pyelonephritis following cystitis in women and explore if antibiotic treatment, cervical cancer, parity, and sociodemographic factors are related to these risks. Methods: This was a nationwide cohort study (2006–2018) of 752,289 women diagnosed with uncomplicated cystitis in primary healthcare settings. Of these, 404 696 did not redeem an antibiotic prescription within five days from cystitis. Logistic regression models were used to calculate odds ratios for... (More)
Background: The risk of pyelonephritis following uncomplicated lower urinary tract infection (cystitis) in women has not been studied in well-powered samples. This is likely due to the previous lack of nationwide primary healthcare data. We aimed to examine the risks of pyelonephritis following cystitis in women and explore if antibiotic treatment, cervical cancer, parity, and sociodemographic factors are related to these risks. Methods: This was a nationwide cohort study (2006–2018) of 752,289 women diagnosed with uncomplicated cystitis in primary healthcare settings. Of these, 404 696 did not redeem an antibiotic prescription within five days from cystitis. Logistic regression models were used to calculate odds ratios for pyelonephritis within 30 days and 90 days following the cystitis event. Results: Around one percent (7454) of all women with cystitis were diagnosed with pyelonephritis within 30 days, of which 78.2% had not redeemed an antibiotic for their cystitis. Antibiotic treatment was inversely associated with both outpatient registration and hospitalization due to pyelonephritis, with odds ratios of 0.85 (95% CI 0.80 to 0.91) and 0.65 (95% CI 0.55 to 0.77), respectively. Sociodemographic factors, parity, and cervical cancer were, with few exceptions (e.g., age and region of residency), not associated with pyelonephritis. Conclusions: Antibiotic treatment was inversely associated with pyelonephritis, but the absolute risk reduction was low. Non-antibiotic treatment for cystitis might be a safe option for most women. Future studies identifying the women at the highest risks will help clinicians in their decision making when treating cystitis, while keeping the ecological costs of antibiotics in mind.
(Less)
- author
- Jansåker, Filip LU ; Li, Xinjun LU ; Vik, Ingvild ; Frimodt-Møller, Niels ; Knudsen, Jenny Dahl and Sundquist, Kristina LU
- organization
- publishing date
- 2022-12
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- antibiotics, cervical cancer, complications, cystitis, parity, pyelonephritis, sociodemographic factors, treatment
- in
- Antibiotics
- volume
- 11
- issue
- 12
- article number
- 1695
- publisher
- MDPI AG
- external identifiers
-
- scopus:85144701576
- pmid:36551352
- ISSN
- 2079-6382
- DOI
- 10.3390/antibiotics11121695
- language
- English
- LU publication?
- yes
- id
- f019eae9-7498-4f46-bc39-5cd0866601fa
- date added to LUP
- 2023-01-05 12:09:38
- date last changed
- 2024-12-13 19:06:35
@article{f019eae9-7498-4f46-bc39-5cd0866601fa,
abstract = {{<p>Background: The risk of pyelonephritis following uncomplicated lower urinary tract infection (cystitis) in women has not been studied in well-powered samples. This is likely due to the previous lack of nationwide primary healthcare data. We aimed to examine the risks of pyelonephritis following cystitis in women and explore if antibiotic treatment, cervical cancer, parity, and sociodemographic factors are related to these risks. Methods: This was a nationwide cohort study (2006–2018) of 752,289 women diagnosed with uncomplicated cystitis in primary healthcare settings. Of these, 404 696 did not redeem an antibiotic prescription within five days from cystitis. Logistic regression models were used to calculate odds ratios for pyelonephritis within 30 days and 90 days following the cystitis event. Results: Around one percent (7454) of all women with cystitis were diagnosed with pyelonephritis within 30 days, of which 78.2% had not redeemed an antibiotic for their cystitis. Antibiotic treatment was inversely associated with both outpatient registration and hospitalization due to pyelonephritis, with odds ratios of 0.85 (95% CI 0.80 to 0.91) and 0.65 (95% CI 0.55 to 0.77), respectively. Sociodemographic factors, parity, and cervical cancer were, with few exceptions (e.g., age and region of residency), not associated with pyelonephritis. Conclusions: Antibiotic treatment was inversely associated with pyelonephritis, but the absolute risk reduction was low. Non-antibiotic treatment for cystitis might be a safe option for most women. Future studies identifying the women at the highest risks will help clinicians in their decision making when treating cystitis, while keeping the ecological costs of antibiotics in mind.</p>}},
author = {{Jansåker, Filip and Li, Xinjun and Vik, Ingvild and Frimodt-Møller, Niels and Knudsen, Jenny Dahl and Sundquist, Kristina}},
issn = {{2079-6382}},
keywords = {{antibiotics; cervical cancer; complications; cystitis; parity; pyelonephritis; sociodemographic factors; treatment}},
language = {{eng}},
number = {{12}},
publisher = {{MDPI AG}},
series = {{Antibiotics}},
title = {{The Risk of Pyelonephritis Following Uncomplicated Cystitis : A Nationwide Primary Healthcare Study}},
url = {{http://dx.doi.org/10.3390/antibiotics11121695}},
doi = {{10.3390/antibiotics11121695}},
volume = {{11}},
year = {{2022}},
}