Safe and Effective Treatment of Patients with Urinary Tract Infections Caused by Extended-Spectrum Beta Lactamase-Producing Enterobacteriaceae via Telemedicine-Controlled Hospital at Home: A Case Series of 11 Patients
Abstract
BACKGROUND: Resistant bacteria causing urinary tract infections (UTI) are becoming increasingly common worldwide. Patients suffering from such UTIs are often elderly, with complex medical backgrounds, and require prolonged hospital stays due to the frequent need for intravenous antibiotics. The alternative hospital-at-home (HAH) option for such patients should, therefore, be explored.
METHODS: We present our experience in the treatment of patients with extended-spectrum beta-lactamase (ESBL) infections treated through our HAH service.
RESULTS: Eleven such patients were included in our HAH service between February 2022 and December 2023 (median age: 79 years; 64% females; 57% had diabetes mellitus in their background). Of these patients, 27.2% had urinary instrumentations and 81.8% had a history of previous UTIs, of which 77.7% had resistant bacteria. The most common pathogen (7 out of 9 patients) was Escherichia coli. All eleven pathogens were resistant to ceftriaxone and ciprofloxacin. The mean length of hospitalization was 5 ± 2 days. Eight patients (72.7%) did not experience recurrent UTIs. Only two patients (18.2%) experienced acute kidney injury, which resolved during their HAH stay. Two patients died during a 30-day follow up from causes unrelated to their UTI.
CONCLUSIONS: Treatment of patients presenting with urinary tract infections with resistant ESBL pathogens in the setting of a telemedicine-assisted, hospital-at-home setting is both effective and safe.
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 9 participants or records.
Read the paper
Related studies
- Association of lower urinary tract symptoms and OAB severity with quality of life and mental health in China, Taiwan and South Korea: results from a cross-sectional, population-based study
- Ten-Day Quadruple Therapy Comprising Low-Dose Rabeprazole, Bismuth, Amoxicillin, and Tetracycline Is an Effective and Safe First-Line Treatment for Helicobacter pylori Infection in a Population with High Antibiotic Resistance: a Prospective, Multicenter, Randomized, Parallel-Controlled Clinical Trial in China
- The Role of the NLR and PLR in Urinary Tract Infection
- Threat of Antimicrobial Resistance among Pilgrims with Infectious Diseases during Hajj: Lessons Learnt from COVID-19 Pandemic
- Leclercia adecarboxylata urinary tract infection in a patient with bladder cancer and recurrent hematuria
- A Case Series of Staphylococcus lugdunensis Infection in Cancer Patients at an Academic Cancer Institute in the United States
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.