Use of Machine Learning to Assess the Management of Uncomplicated Urinary Tract Infection
Abstract
IMPORTANCE: Uncomplicated urinary tract infection (UTI) is a common indication for outpatient antimicrobial therapy. National guidelines for the management of uncomplicated UTI were published in 2011, but the extent to which they align with current practices, patient diversity, and pathogen biology, all of which have evolved greatly in the time since their publication, is not fully known.
OBJECTIVE: To reevaluate the effectiveness and adverse event profile for first-line antibiotics, fluoroquinolones, and oral β-lactams for treating uncomplicated UTI in contemporary clinical practice.
DESIGN, SETTING, AND PARTICIPANTS: This retrospective, population-based cohort study used a claims dataset from Independence Blue Cross, which contains inpatient, outpatient, laboratory, and pharmacy claims that occurred between 2012 and 2021, formatted into the Observational Medical Outcomes Partnership (OMOP) common data model. Participants were nonpregnant female individuals aged 18 years or older with a diagnosis of uncomplicated, nonrecurrent UTI at an outpatient setting. Patients must also have been treated with first-line (nitrofurantoin or trimethoprim-sulfamethoxazole), fluoroquinolone (ciprofloxacin, levofloxacin, or ofloxacin), or oral β-lactam (amoxicillin-clavulanate, cefadroxil, or cefpodoxime) antibiotics. Data analysis was performed from November 2021 to August 2024.
EXPOSURES: Patients exposed to first-line antibiotics were assigned to the treatment group, and those exposed to…
How strong is the evidence?
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. Reported size: 49 participants or records.
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