Risk of recurrent acute lower urinary tract infections and prescription pattern of antibiotics in women with and without diabetes in primary care
Risk of recurrent acute lower urinary tract infections and prescription pattern of antibiotics in women with and without diabetes in primary care
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DOI：
10.1093/fampra/cmq026
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发表时间：
2010-08-01
期刊：
影响因子：
2.2
通讯作者：
Rutten, Guy E. H. M.
中科院分区：
文献类型：
--
作者：
Gorter, Kees J.;Hak, Eelko;Rutten, Guy E. H. M.
目的。调查与复发性下尿路感染风险和抗生素处方模式相关的糖尿病特征。方法。在一项涉及 7063 名 30 岁以上女性的探索性回顾性研究中，我们研究了患有糖尿病 (n = 340) 和未患糖尿病 (n = 6618) 的女性复发性 UTI（复发和再感染）的发生率。使用多变量逻辑回归和多水平多项逻辑分析来确定糖尿病特征与复发性尿路感染之间的调整关联[优势比（OR）； 95% 置信区间 (CI)] 和糖尿病对 UTI 抗生素处方模式的影响。结果。据报道，患有糖尿病的女性中有 7.1% 和 15.9% 出现复发和再感染，而未患糖尿病的女性则分别有 2.0% 和 4.1% 出现复发和再感染。与非糖尿病女性相比，糖尿病女性复发性尿路感染的独立风险较高（OR 2.0；95% CI 1.4-2.9）。服用口服降血糖药物（OR 2.1；95% CI 1.2-3.5）或胰岛素（OR 3.0；95% CI 1.7-5.1）或患有糖尿病>= 5年（OR 2.9；95% CI 1.9-4.4）或患有视网膜病变（OR 4.1；95% CI 1.9-9.1）的女性面临以下风险：复发性尿路感染。尿路感染的抗生素处方模式不受糖尿病的影响。结论。患有糖尿病 >= 5 岁或服用降糖药物或患有视网膜病变的女性复发性尿路感染的风险增加。糖尿病本身似乎并不影响抗生素处方模式。需要开展针对有复发风险的女性尿路感染有效抗生素治疗的研究，这可能有助于限制抗生素耐药性的发展。
Aim. To investigate diabetes characteristics associated with the risk of recurrent lower UTIs and the antibiotic prescription pattern.Methods. In an exploratory retrospective study involving 7063 women aged >= 30 years, we studied the incidence of recurrent UTI (relapses and reinfection) in women with (n = 340) and without diabetes (n = 6618). Multivariable logistic regression and multilevel multinomial logistic analyses were used to determine the adjusted associations between diabetes characteristics and recurrent UTI [odds ratio (OR); 95% confidence interval (CI)] and the influence of diabetes on the pattern of antibiotic prescriptions for UTI, respectively.Results. Relapses and reinfections were reported in 7.1% and 15.9% of women with diabetes versus 2.0% and 4.1% of women without diabetes. There was an independent higher risk of recurrent UTI in women with diabetes compared with women without diabetes (OR 2.0; 95% CI 1.4-2.9). Women taking oral blood glucose-lowering medication (OR 2.1; 95% CI 1.2-3.5) or insulin (OR 3.0; 95% CI 1.7-5.1) or who had had diabetes for >= 5 years (OR 2.9; 95% CI 1.9-4.4) or who had retinopathy (OR 4.1; 95% CI 1.9-9.1) were at risk of recurrent UTI. The pattern of antibiotic prescriptions for UTI was not influenced by diabetes.Conclusions. Women with diabetes >= 5 years or with glucose-lowering medication or with retinopathy have an increased risk of recurrent UTI. Diabetes itself does not seem to influence the antibiotic prescription pattern. Research focusing on effective antibiotic treatment of UTI in women at risk of recurrence is needed and may help limit the development of antibiotic resistance.