Incidence and antibiotic prescribing for clinically diagnosed urinary tract infection in older adults in UK primary care, 2004-2014.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
  • Additional Information
    • Source:
      Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
    • Publication Information:
      Original Publication: San Francisco, CA : Public Library of Science
    • Subject Terms:
    • Abstract:
      Urinary tract infections (UTI) are an important cause of morbidity and antibiotic use in older adults but there are little data describing disease burden in primary care. The aim of this study was to estimate the incidence of clinically diagnosed UTI and examine associated empirical antibiotic prescribing. We conducted a retrospective observational study using linked health records from almost one million patients aged ≥65 years old, registered with 393 primary care practices in England. We estimated incidence of clinically diagnosed UTI between March 2004 and April 2014, and used multilevel logistic regression to examine trends in empiric antibiotic prescribing. Of 931,945 older adults, 196,358 (21%) had at least one clinically diagnosed UTI over the study period. In men, the incidence of clinically diagnosed UTI per 100 person-years at risk increased from 2.81 to 3.05 in those aged 65-74, 5.90 to 6.13 in those aged 75-84, and 8.08 to 10.54 in those aged 85+. In women, incidence increased from 9.03 to 10.96 in those aged 65-74, 11.35 to 14.34 in those aged 75-84, and 14.65 to 19.80 in those aged 85+. Prescribing of broad-spectrum antibiotics decreased over the study period. There were increases in the proportion of older men (from 45% to 74%) and women (from 55% to 82%) with UTI, prescribed a UTI specific antibiotic. There were also increases in the proportion of older men (42% to 69%) and women (15% to 26%) prescribed antibiotics for durations recommended by clinical guidelines. This is the first population-based study describing the burden of UTI in UK primary care. Our findings suggest a need to better understand reasons for increasing rates of clinically diagnosed UTI and consider how best to address this important clinical problem.
    • References:
      Fam Pract. 2011 Jun;28(3):294-9. (PMID: 21127022)
      BMC Med. 2011 May 16;9:57. (PMID: 21575195)
      Infect Control Hosp Epidemiol. 2001 Feb;22(2):120-4. (PMID: 11232875)
      BMJ. 2005 Sep 24;331(7518):669. (PMID: 16150741)
      Diabet Med. 2014 May;31(5):606-14. (PMID: 24341529)
      BMJ. 2010 May 18;340:c2096. (PMID: 20483949)
      Drugs Aging. 2011 Oct 1;28(10):819-29. (PMID: 21970309)
      BMJ Open. 2013 Jan 02;3(1):null. (PMID: 23288268)
      Popul Health Metr. 2017 Jul 1;15(1):23. (PMID: 28668081)
      Cochrane Database Syst Rev. 2008 Jul 16;(3):CD001535. (PMID: 18646074)
      J Epidemiol Community Health. 1983 Dec;37(4):286-90. (PMID: 6655418)
      JAMA Intern Med. 2013 Jan 14;173(1):62-8. (PMID: 23212273)
      PLoS One. 2013 Oct 25;8(10):e76020. (PMID: 24204587)
      PLoS Med. 2015 Oct 06;12(10):e1001885. (PMID: 26440803)
      J Am Geriatr Soc. 2009 Jun;57(6):963-70. (PMID: 19490243)
      Int J Epidemiol. 2015 Jun;44(3):827-36. (PMID: 26050254)
      Open Forum Infect Dis. 2017 Feb 24;4(1):ofw281. (PMID: 28480273)
      PLoS One. 2013 Sep 11;8(9):e75131. (PMID: 24040394)
      J Clin Epidemiol. 2016 Jul;75:66-9. (PMID: 26776084)
      CMAJ. 2000 Aug 8;163(3):273-7. (PMID: 10951723)
      J Antimicrob Chemother. 2012 Jul;67(7):1781-90. (PMID: 22438433)
      Health Technol Assess. 2014 Oct;18(63):1-84. (PMID: 25331573)
      Scand J Prim Health Care. 2013 Dec;31(4):235-40. (PMID: 24102498)
      Pharm World Sci. 2005 Jun;27(3):159-65. (PMID: 16096881)
      Inform Prim Care. 2011;19(3):173-82. (PMID: 22688227)
    • Grant Information:
      G0902108 United Kingdom MRC_ Medical Research Council; HCRW_NIHR-FS-2014 United Kingdom HCRW HCRW_; MR/K006525/1 United Kingdom MRC_ Medical Research Council
    • Accession Number:
      0 (Anti-Bacterial Agents)
    • Publication Date:
      Date Created: 20180106 Date Completed: 20180215 Latest Revision: 20220716
    • Publication Date:
      20240105
    • Accession Number:
      PMC5755802
    • Accession Number:
      10.1371/journal.pone.0190521
    • Accession Number:
      29304056