ArticleDrug safety2013
Angiotensin-converting enzyme inhibitor treatment and the development of urinary tract infections: a prescription sequence symmetry analysis.
Article in Drug safety, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.
What it found
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Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Prescribing Cascades with Recommendations to Prevent or Reverse Them: A Systematic Review.Drugs & aging · 2023Pooled it
- Prescribing cascades in community-dwelling adults: A systematic review.Pharmacology research & perspectives · 2022Pooled it
- Pooled it
- Dose-dependent relationships in potential prescribing cascades: a cohort study using community pharmacy dispensing data.International journal of clinical pharmacy · 2026Article
- Association between coronavirus disease 2019 and new-onset autoimmune diseases during the early phase of the pandemic.PloS one · 2026Article
- High-Throughput Screening for Prescribing Cascades Among Real-World Angiotensin-Converting Enzyme Inhibitor Initiators.Pharmacoepidemiology and drug safety · 2025Article
- Safety of dapagliflozin and empagliflozin in cases with diabetes mellitus or/and heart failure: a retrospective pharmacovigilance study conducted on the eudravigilance database.Pharmacological reports : PR · 2025Article
- Impact of recently initiated medications on the incidence of urinary tract infections in patients with type 2 diabetes: an observational case-control study.Therapeutic advances in drug safety · 2025Article
- Identifying and quantifying potentially problematic prescribing cascades in clinical practice: A mixed-methods study.Journal of the American Geriatrics Society · 2024Article
- Prescription Sequence Symmetry Analysis (PSSA) to assess prescribing cascades: a step-by-step guide.BMC medical research methodology · 2024Article
- Uropathogen and host responses in pyelonephritis.Nature reviews. Nephrology · 2023Review
- Association between antihypertensive medication and the risk of urinary tract infection (UTI) of outpatients: a retrospective cohort study.Infection · 2023Article
- Risk of neuropsychiatric adverse events associated with varenicline treatment for smoking cessation among Dutch population: A sequence symmetry analysis.Pharmacoepidemiology and drug safety · 2022Article
- Increased risk of mycotic infections associated with sodium-glucose co-transporter 2 inhibitors: a prescription sequence symmetry analysis.British journal of clinical pharmacology · 2019Observational
- Risk Evaluation for Acute Kidney Injury Induced by the Concomitant Use of Valacyclovir, Analgesics, and Renin-Angiotensin System Inhibitors: The Detection of Signals of Drug-Drug Interactions.Frontiers in pharmacology · 2019Article
- Selection and co-selection of antibiotic resistances among Escherichia coli by antibiotic use in primary care: An ecological analysis.PloS one · 2019Article
- Signal Detection Between Fluoroquinolone Use and the Risk of Rhegmatogenous Retinal Detachment: Sequence Symmetry Analysis Using Nationwide South Korean Healthcare Database Between 2004 and 2015.Clinical drug investigation · 2018Article
- Assessment of Medication Safety Using Only Dispensing Data.Current epidemiology reports · 2018Review
- Sequence symmetry analysis in pharmacovigilance and pharmacoepidemiologic studies.European journal of epidemiology · 2017Review
- Association between statins and infections among patients with diabetes: a cohort and prescription sequence symmetry analysis.Pharmacoepidemiology and drug safety · 2016 · on this mapObservational
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAngiotensin-converting enzyme inhibitors (ACEi) can reduce urine output, especially when treatment is first started. Since bacterial clearance from the urinary tract is dependent on urine output, it was hypothesized that ACEi may also increase the risk of urinary tract infections (UTIs).
objectiveOur objective was to assess the risk of UTIs associated with ACEi therapy initiation in the general population.
methodsA prescription sequence symmetry analysis was performed with the Dutch 'InterAction Database' (IADB.nl) pharmacy prescription database. We selected all patients from the IADB who were incident users of both ACEi and nitrofurantoin (a proxy for UTIs). A relatively short maximum time-span of 4 weeks between both prescriptions was used to limit time-variant confounding. The sequence ratio was calculated by dividing the number of individuals starting ACEi first and nitrofurantoin second by the number of individuals starting nitrofurantoin treatment first and ACEi second. We adjusted for trends in prescribing and estimated 95 % confidence intervals using exact confidence intervals for binomial distributions. To evaluate whether the effect is specific to ACEi and to assess whether the possible mechanism behind an increased risk of UTIs is related to the renin-angiotensin-aldosterone system, we also estimated the risk for β-adrenoceptor antagonists (β-blockers).
resultsIn total, 22,959 incident users of ACEi therapy were eligible for analysis. Of these, 161 patients started ACEi therapy within 4 weeks prior to or after nitrofurantoin therapy initiation. A total of 101 (63 %) started ACEi therapy first followed by nitrofurantoin treatment, while 60 (37 %) patients started nitrofurantoin treatment first, which corresponds to a statistically significant adjusted sequence ratio (ASR) of 1.68 (95 % CI 1.21-2.36). No association was found between β-blockers and UTI treatment (ASR 1.01, 95 % CI 0.74-1.38).
conclusionsA significant excess of patients received UTI medication prescriptions following the first month after ACEi initiation. This prescription sequence asymmetry suggests that ACEi initiation increases the risk of developing UTIs.
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