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Nitrofurantoin Failure in Elderly Men: A Retrospective Observational Study

Urinary tract infections in the elderly are common. Treatment with nitrofurantoin in men may not be sufficient if concomitant tissue involvement is present, resulting in treatment failure. The aim of this study is to determine the prevalence of nitrofurantoin failure in the elderly, and to assess th...

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Autores principales: Wolterink, Ilse, Verheij, Theo, Platteel, Tamara, van den Bruel, Ann, Stam, Arjen, van de Pol, Alma
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7277082/
https://www.ncbi.nlm.nih.gov/pubmed/32349325
http://dx.doi.org/10.3390/antibiotics9050211
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author Wolterink, Ilse
Verheij, Theo
Platteel, Tamara
van den Bruel, Ann
Stam, Arjen
van de Pol, Alma
author_facet Wolterink, Ilse
Verheij, Theo
Platteel, Tamara
van den Bruel, Ann
Stam, Arjen
van de Pol, Alma
author_sort Wolterink, Ilse
collection PubMed
description Urinary tract infections in the elderly are common. Treatment with nitrofurantoin in men may not be sufficient if concomitant tissue involvement is present, resulting in treatment failure. The aim of this study is to determine the prevalence of nitrofurantoin failure in the elderly, and to assess the effect of gender and age. A retrospective observational study was conducted using a Dutch general practice medical record database of 21,789 men and 26,622 women aged 65 years or older in 2015. First, nitrofurantoin prescriptions in 2015 were analyzed. Nitrofurantoin failure (subsequent prescription of antibiotic within 30 days) for men, women, and different age categories were compared. The effect of age and gender was assessed using multivariate logistic regression. A total of 3537 patients had a first nitrofurantoin prescription in 2015; 506 men and 3031 women. Overall, 584 patients (17%) experienced nitrofurantoin failure; 135 (27%) men and 449 (15%) women. Male gender (odds ratio (OR) = 2.09, 95% confidence interval (CI) 1.68–2.61) and age (OR = 1.02, 95% CI 1.01–1.03) was associated with higher treatment failure. Our findings indicate that in a substantial number of elderly men, nitrofurantoin might not be the appropriate treatment. Nitrofurantoin, as a first choice in elderly men with urinary tract infections, should be reconsidered.
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spelling pubmed-72770822020-06-15 Nitrofurantoin Failure in Elderly Men: A Retrospective Observational Study Wolterink, Ilse Verheij, Theo Platteel, Tamara van den Bruel, Ann Stam, Arjen van de Pol, Alma Antibiotics (Basel) Article Urinary tract infections in the elderly are common. Treatment with nitrofurantoin in men may not be sufficient if concomitant tissue involvement is present, resulting in treatment failure. The aim of this study is to determine the prevalence of nitrofurantoin failure in the elderly, and to assess the effect of gender and age. A retrospective observational study was conducted using a Dutch general practice medical record database of 21,789 men and 26,622 women aged 65 years or older in 2015. First, nitrofurantoin prescriptions in 2015 were analyzed. Nitrofurantoin failure (subsequent prescription of antibiotic within 30 days) for men, women, and different age categories were compared. The effect of age and gender was assessed using multivariate logistic regression. A total of 3537 patients had a first nitrofurantoin prescription in 2015; 506 men and 3031 women. Overall, 584 patients (17%) experienced nitrofurantoin failure; 135 (27%) men and 449 (15%) women. Male gender (odds ratio (OR) = 2.09, 95% confidence interval (CI) 1.68–2.61) and age (OR = 1.02, 95% CI 1.01–1.03) was associated with higher treatment failure. Our findings indicate that in a substantial number of elderly men, nitrofurantoin might not be the appropriate treatment. Nitrofurantoin, as a first choice in elderly men with urinary tract infections, should be reconsidered. MDPI 2020-04-27 /pmc/articles/PMC7277082/ /pubmed/32349325 http://dx.doi.org/10.3390/antibiotics9050211 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wolterink, Ilse
Verheij, Theo
Platteel, Tamara
van den Bruel, Ann
Stam, Arjen
van de Pol, Alma
Nitrofurantoin Failure in Elderly Men: A Retrospective Observational Study
title Nitrofurantoin Failure in Elderly Men: A Retrospective Observational Study
title_full Nitrofurantoin Failure in Elderly Men: A Retrospective Observational Study
title_fullStr Nitrofurantoin Failure in Elderly Men: A Retrospective Observational Study
title_full_unstemmed Nitrofurantoin Failure in Elderly Men: A Retrospective Observational Study
title_short Nitrofurantoin Failure in Elderly Men: A Retrospective Observational Study
title_sort nitrofurantoin failure in elderly men: a retrospective observational study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7277082/
https://www.ncbi.nlm.nih.gov/pubmed/32349325
http://dx.doi.org/10.3390/antibiotics9050211
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