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Treatment duration of pivmecillinam in men, non-pregnant and pregnant women for community-acquired urinary tract infections caused by Escherichia coli: a retrospective Danish cohort study.
- Source :
-
The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2019 Sep 01; Vol. 74 (9), pp. 2767-2773. - Publication Year :
- 2019
-
Abstract
- Objectives: To evaluate the importance of treatment duration for therapeutic efficacy of pivmecillinam for community-acquired urinary tract infections (UTIs) caused by Escherichia coli.<br />Methods: A retrospective cohort study was conducted between 1 January 2010 and 30 September 2016 in adults with community-acquired E. coli bacteriuria, treated empirically with pivmecillinam. Regimens of 3, 5 and 7 days were compared using clinical treatment failure (i.e. redemption of a new antibiotic or hospitalization due to UTI) within 14 and 30 days as outcome. HR and risk difference with 95% CI were estimated for treatment failure. Results were stratified by age (18-50, 51-70, >70 years) and sex.<br />Results: Of the 21864 cases of E. coli UTI that were analysed, 2524 (11.5%) were in men. In 954 cases (4.4%) E. coli produced ESBL and 125 (13.1%) of the cases were in men. The 3 day regimen increased the risk of treatment failure for all groups. The risk differences between the 3 and 5 day regimens were <10% for women, but >10% for men. Comparing the 7 day and 5 day regimens, only women aged >50 years demonstrated an increased risk of treatment failure within 14 days with the 5 day regimen, but not within 30 days.<br />Conclusions: With the current data, where data on clinical classification of the E. coli UTI were missing, a 5 day treatment with pivmecillinam at 400 mg three times daily seems to be the rational recommendation for lower UTI in men, pregnant women and women >50 years old. A 3 day regimen seems sufficient for non-pregnant women <50 years old.<br /> (© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Amdinocillin Pivoxil administration & dosage
Amdinocillin Pivoxil adverse effects
Anti-Infective Agents, Urinary administration & dosage
Anti-Infective Agents, Urinary adverse effects
Anti-Infective Agents, Urinary therapeutic use
Community-Acquired Infections microbiology
Denmark epidemiology
Duration of Therapy
Escherichia coli
Escherichia coli Infections microbiology
Female
Hospitalization
Humans
Male
Middle Aged
Practice Patterns, Physicians'
Pregnancy
Public Health Surveillance
Registries
Retrospective Studies
Treatment Outcome
Young Adult
Amdinocillin Pivoxil therapeutic use
Community-Acquired Infections drug therapy
Community-Acquired Infections epidemiology
Escherichia coli Infections drug therapy
Escherichia coli Infections epidemiology
Urinary Tract Infections drug therapy
Urinary Tract Infections epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1460-2091
- Volume :
- 74
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- The Journal of antimicrobial chemotherapy
- Publication Type :
- Academic Journal
- Accession number :
- 31098630
- Full Text :
- https://doi.org/10.1093/jac/dkz211