Predicting the use of antibiotics after initial symptomatic treatment of an uncomplicated urinary tract infection: analyses performed after a randomised controlled trial

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Predicting the use of antibiotics after initial symptomatic treatment of an uncomplicated urinary tract infection : analyses performed after a randomised controlled trial. / Vik, Ingvild; Mdala, Ibrahimu; Bollestad, Marianne; Cordoba, Gloria Cristina; Bjerrum, Lars; Neumark, Thomas; Damsgaard, Eivind; Bærheim, Anders; Grude, Nils; Lindbaek, Morten.

In: BMJ Open, Vol. 10, No. 8, e035074, 30.08.2020.

Research output: Contribution to journalJournal articleResearchpeer-review

Harvard

Vik, I, Mdala, I, Bollestad, M, Cordoba, GC, Bjerrum, L, Neumark, T, Damsgaard, E, Bærheim, A, Grude, N & Lindbaek, M 2020, 'Predicting the use of antibiotics after initial symptomatic treatment of an uncomplicated urinary tract infection: analyses performed after a randomised controlled trial', BMJ Open, vol. 10, no. 8, e035074. https://doi.org/10.1136/bmjopen-2019-035074

APA

Vik, I., Mdala, I., Bollestad, M., Cordoba, G. C., Bjerrum, L., Neumark, T., ... Lindbaek, M. (2020). Predicting the use of antibiotics after initial symptomatic treatment of an uncomplicated urinary tract infection: analyses performed after a randomised controlled trial. BMJ Open, 10(8), [e035074]. https://doi.org/10.1136/bmjopen-2019-035074

Vancouver

Vik I, Mdala I, Bollestad M, Cordoba GC, Bjerrum L, Neumark T et al. Predicting the use of antibiotics after initial symptomatic treatment of an uncomplicated urinary tract infection: analyses performed after a randomised controlled trial. BMJ Open. 2020 Aug 30;10(8). e035074. https://doi.org/10.1136/bmjopen-2019-035074

Author

Vik, Ingvild ; Mdala, Ibrahimu ; Bollestad, Marianne ; Cordoba, Gloria Cristina ; Bjerrum, Lars ; Neumark, Thomas ; Damsgaard, Eivind ; Bærheim, Anders ; Grude, Nils ; Lindbaek, Morten. / Predicting the use of antibiotics after initial symptomatic treatment of an uncomplicated urinary tract infection : analyses performed after a randomised controlled trial. In: BMJ Open. 2020 ; Vol. 10, No. 8.

Bibtex

@article{e9cb4cfc57bb42e1a499289ba056f6c2,
title = "Predicting the use of antibiotics after initial symptomatic treatment of an uncomplicated urinary tract infection: analyses performed after a randomised controlled trial",
abstract = "OBJECTIVE: To predict antibiotic use after initial treatment with ibuprofen using data from a randomised controlled trial comparing ibuprofen to pivmecillinam in the treatment of women with symptoms of an uncomplicated urinary tract infection (UTI).SETTING: 16 sites in a primary care setting in Norway, Sweden and Denmark.PARTICIPANTS: Data from 181 non-pregnant women aged 18-60 presenting with symptoms of uncomplicated UTI, initially treated with ibuprofen.METHODS: Using the least absolute shrinkage and selection operator logistic regression model, we conducted analyses to see if baseline information could help us predict which women could be treated with ibuprofen without risking treatment failure and which women should be recommended antibiotics.RESULTS: Of the 143 women included in the final analysis, 77 (53.8{\%}) recovered without antibiotics and 66 (46.2 {\%}) were subsequently prescribed antibiotics. In the unadjusted binary logistic regression, the number of days with symptoms before inclusion (<3 days) and feeling moderately unwell or worse (≥4 on a scale of 0-6) were significant predictors for subsequent antibiotic use. In the adjusted model, no predictors were significantly associated with subsequent antibiotic use. The area under the curve of the final model was 0.66 (95{\%} CI: 0.57 to 0.74).CONCLUSION: We did not find any baseline information that significantly predicted the use of antibiotic treatment. Identifying women who need antibiotic treatment to manage their uncomplicated UTI is still challenging. Larger data sets are needed to develop models that are more accurate.TRIAL REGISTRATION NUMBER: ClinicalTrials.gov (NCT01849926).",
author = "Ingvild Vik and Ibrahimu Mdala and Marianne Bollestad and Cordoba, {Gloria Cristina} and Lars Bjerrum and Thomas Neumark and Eivind Damsgaard and Anders B{\ae}rheim and Nils Grude and Morten Lindbaek",
note = "{\circledC} Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2020",
month = "8",
day = "30",
doi = "10.1136/bmjopen-2019-035074",
language = "English",
volume = "10",
journal = "B M J Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "8",

}

RIS

TY - JOUR

T1 - Predicting the use of antibiotics after initial symptomatic treatment of an uncomplicated urinary tract infection

T2 - analyses performed after a randomised controlled trial

AU - Vik, Ingvild

AU - Mdala, Ibrahimu

AU - Bollestad, Marianne

AU - Cordoba, Gloria Cristina

AU - Bjerrum, Lars

AU - Neumark, Thomas

AU - Damsgaard, Eivind

AU - Bærheim, Anders

AU - Grude, Nils

AU - Lindbaek, Morten

N1 - © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2020/8/30

Y1 - 2020/8/30

N2 - OBJECTIVE: To predict antibiotic use after initial treatment with ibuprofen using data from a randomised controlled trial comparing ibuprofen to pivmecillinam in the treatment of women with symptoms of an uncomplicated urinary tract infection (UTI).SETTING: 16 sites in a primary care setting in Norway, Sweden and Denmark.PARTICIPANTS: Data from 181 non-pregnant women aged 18-60 presenting with symptoms of uncomplicated UTI, initially treated with ibuprofen.METHODS: Using the least absolute shrinkage and selection operator logistic regression model, we conducted analyses to see if baseline information could help us predict which women could be treated with ibuprofen without risking treatment failure and which women should be recommended antibiotics.RESULTS: Of the 143 women included in the final analysis, 77 (53.8%) recovered without antibiotics and 66 (46.2 %) were subsequently prescribed antibiotics. In the unadjusted binary logistic regression, the number of days with symptoms before inclusion (<3 days) and feeling moderately unwell or worse (≥4 on a scale of 0-6) were significant predictors for subsequent antibiotic use. In the adjusted model, no predictors were significantly associated with subsequent antibiotic use. The area under the curve of the final model was 0.66 (95% CI: 0.57 to 0.74).CONCLUSION: We did not find any baseline information that significantly predicted the use of antibiotic treatment. Identifying women who need antibiotic treatment to manage their uncomplicated UTI is still challenging. Larger data sets are needed to develop models that are more accurate.TRIAL REGISTRATION NUMBER: ClinicalTrials.gov (NCT01849926).

AB - OBJECTIVE: To predict antibiotic use after initial treatment with ibuprofen using data from a randomised controlled trial comparing ibuprofen to pivmecillinam in the treatment of women with symptoms of an uncomplicated urinary tract infection (UTI).SETTING: 16 sites in a primary care setting in Norway, Sweden and Denmark.PARTICIPANTS: Data from 181 non-pregnant women aged 18-60 presenting with symptoms of uncomplicated UTI, initially treated with ibuprofen.METHODS: Using the least absolute shrinkage and selection operator logistic regression model, we conducted analyses to see if baseline information could help us predict which women could be treated with ibuprofen without risking treatment failure and which women should be recommended antibiotics.RESULTS: Of the 143 women included in the final analysis, 77 (53.8%) recovered without antibiotics and 66 (46.2 %) were subsequently prescribed antibiotics. In the unadjusted binary logistic regression, the number of days with symptoms before inclusion (<3 days) and feeling moderately unwell or worse (≥4 on a scale of 0-6) were significant predictors for subsequent antibiotic use. In the adjusted model, no predictors were significantly associated with subsequent antibiotic use. The area under the curve of the final model was 0.66 (95% CI: 0.57 to 0.74).CONCLUSION: We did not find any baseline information that significantly predicted the use of antibiotic treatment. Identifying women who need antibiotic treatment to manage their uncomplicated UTI is still challenging. Larger data sets are needed to develop models that are more accurate.TRIAL REGISTRATION NUMBER: ClinicalTrials.gov (NCT01849926).

U2 - 10.1136/bmjopen-2019-035074

DO - 10.1136/bmjopen-2019-035074

M3 - Journal article

C2 - 32868350

VL - 10

JO - B M J Open

JF - B M J Open

SN - 2044-6055

IS - 8

M1 - e035074

ER -

ID: 248162013