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The Risk of Pyelonephritis Following Uncomplicated Cystitis: A Nationwide Primary Healthcare Study
Background: The risk of pyelonephritis following uncomplicated lower urinary tract infection (cystitis) in women has not been studied in well-powered samples. This is likely due to the previous lack of nationwide primary healthcare data. We aimed to examine the risks of pyelonephritis following cyst...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9774091/ https://www.ncbi.nlm.nih.gov/pubmed/36551352 http://dx.doi.org/10.3390/antibiotics11121695 |
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author | Jansåker, Filip Li, Xinjun Vik, Ingvild Frimodt-Møller, Niels Knudsen, Jenny Dahl Sundquist, Kristina |
author_facet | Jansåker, Filip Li, Xinjun Vik, Ingvild Frimodt-Møller, Niels Knudsen, Jenny Dahl Sundquist, Kristina |
author_sort | Jansåker, Filip |
collection | PubMed |
description | Background: The risk of pyelonephritis following uncomplicated lower urinary tract infection (cystitis) in women has not been studied in well-powered samples. This is likely due to the previous lack of nationwide primary healthcare data. We aimed to examine the risks of pyelonephritis following cystitis in women and explore if antibiotic treatment, cervical cancer, parity, and sociodemographic factors are related to these risks. Methods: This was a nationwide cohort study (2006–2018) of 752,289 women diagnosed with uncomplicated cystitis in primary healthcare settings. Of these, 404 696 did not redeem an antibiotic prescription within five days from cystitis. Logistic regression models were used to calculate odds ratios for pyelonephritis within 30 days and 90 days following the cystitis event. Results: Around one percent (7454) of all women with cystitis were diagnosed with pyelonephritis within 30 days, of which 78.2% had not redeemed an antibiotic for their cystitis. Antibiotic treatment was inversely associated with both outpatient registration and hospitalization due to pyelonephritis, with odds ratios of 0.85 (95% CI 0.80 to 0.91) and 0.65 (95% CI 0.55 to 0.77), respectively. Sociodemographic factors, parity, and cervical cancer were, with few exceptions (e.g., age and region of residency), not associated with pyelonephritis. Conclusions: Antibiotic treatment was inversely associated with pyelonephritis, but the absolute risk reduction was low. Non-antibiotic treatment for cystitis might be a safe option for most women. Future studies identifying the women at the highest risks will help clinicians in their decision making when treating cystitis, while keeping the ecological costs of antibiotics in mind. |
format | Online Article Text |
id | pubmed-9774091 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-97740912022-12-23 The Risk of Pyelonephritis Following Uncomplicated Cystitis: A Nationwide Primary Healthcare Study Jansåker, Filip Li, Xinjun Vik, Ingvild Frimodt-Møller, Niels Knudsen, Jenny Dahl Sundquist, Kristina Antibiotics (Basel) Article Background: The risk of pyelonephritis following uncomplicated lower urinary tract infection (cystitis) in women has not been studied in well-powered samples. This is likely due to the previous lack of nationwide primary healthcare data. We aimed to examine the risks of pyelonephritis following cystitis in women and explore if antibiotic treatment, cervical cancer, parity, and sociodemographic factors are related to these risks. Methods: This was a nationwide cohort study (2006–2018) of 752,289 women diagnosed with uncomplicated cystitis in primary healthcare settings. Of these, 404 696 did not redeem an antibiotic prescription within five days from cystitis. Logistic regression models were used to calculate odds ratios for pyelonephritis within 30 days and 90 days following the cystitis event. Results: Around one percent (7454) of all women with cystitis were diagnosed with pyelonephritis within 30 days, of which 78.2% had not redeemed an antibiotic for their cystitis. Antibiotic treatment was inversely associated with both outpatient registration and hospitalization due to pyelonephritis, with odds ratios of 0.85 (95% CI 0.80 to 0.91) and 0.65 (95% CI 0.55 to 0.77), respectively. Sociodemographic factors, parity, and cervical cancer were, with few exceptions (e.g., age and region of residency), not associated with pyelonephritis. Conclusions: Antibiotic treatment was inversely associated with pyelonephritis, but the absolute risk reduction was low. Non-antibiotic treatment for cystitis might be a safe option for most women. Future studies identifying the women at the highest risks will help clinicians in their decision making when treating cystitis, while keeping the ecological costs of antibiotics in mind. MDPI 2022-11-24 /pmc/articles/PMC9774091/ /pubmed/36551352 http://dx.doi.org/10.3390/antibiotics11121695 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Jansåker, Filip Li, Xinjun Vik, Ingvild Frimodt-Møller, Niels Knudsen, Jenny Dahl Sundquist, Kristina The Risk of Pyelonephritis Following Uncomplicated Cystitis: A Nationwide Primary Healthcare Study |
title | The Risk of Pyelonephritis Following Uncomplicated Cystitis: A Nationwide Primary Healthcare Study |
title_full | The Risk of Pyelonephritis Following Uncomplicated Cystitis: A Nationwide Primary Healthcare Study |
title_fullStr | The Risk of Pyelonephritis Following Uncomplicated Cystitis: A Nationwide Primary Healthcare Study |
title_full_unstemmed | The Risk of Pyelonephritis Following Uncomplicated Cystitis: A Nationwide Primary Healthcare Study |
title_short | The Risk of Pyelonephritis Following Uncomplicated Cystitis: A Nationwide Primary Healthcare Study |
title_sort | risk of pyelonephritis following uncomplicated cystitis: a nationwide primary healthcare study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9774091/ https://www.ncbi.nlm.nih.gov/pubmed/36551352 http://dx.doi.org/10.3390/antibiotics11121695 |
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