Trends in antibiotic use and treatment failure in community-acquired uncomplicated urinary tract infections treated by family physicians in British Columbia
Abstract
Introduction: In the last decade, the prevalence of antimicrobial resistance (AMR) among uropathogens has risen worldwide. Uncomplicated urinary tract infections (uUTIs) in females are one of the most common reasons for antibiotic prescribing by family physicians (FPs) in Canada. The treatment for this infection is mainly empirical. Considering the impact of inappropriate antibiotic prescription on AMR, it is important to examine the trends of antibiotic use, assess the characteristics of the population, and evaluate treatment failure (TF) while considering local resistance rates in British Columbia (BC). This thesis examined the trends of antibiotic use for uUTI by FPs and TF in community-acquired uUTIs in the female population of BC. Methods: A retrospective cohort study was conducted using linked administrative databases to identify uUTIs episodes in the female population of BC from 2012 to 2023. Antibiotic switch, kidney infection, and sepsis were used as a proxy for TF during the follow-up period of 28 days. Associations between year (change per year), therapy line, and time to TF were estimated using Cox regression analysis. Poisson regression with robust standard errors was used to assess the appropriateness of antibiotic prescription by therapy line over time. Results: Among 1,934,014 uUTI episodes in the female population, 9.4% experienced TF. The rate of physician-treated uUTI episodes showed a downward trend over the study period, with an increased use in…
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Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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