Evidence map›Paper›PMID 32868350›Full record

Trial reportBMJ open2020

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

Ingvild Vik, Ibrahimu Mdala, Marianne Bollestad, Gloria Cristina Cordoba, Lars Bjerrum, Thomas Neumark, Eivind Damsgaard, Anders Bærheim, Nils Grude, Morten Lindbaek

Registry-linked trialOpen access · goldAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01849926 (Ibuprofen Versus Mecillinam for Uncomplicated Cystitis in Adult, Non-pregnant Women), which is not on this map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01849926 phase4completednot on this map

Ibuprofen Versus Mecillinam for Uncomplicated Cystitis in Adult, Non-pregnant Women

TypeinterventionalSponsorUniversity of OsloRan2013 to 2016Enrolled383ConditionsAcute Cystitis (Excl in Pregnancy)ArmsIbuprofen, Mecillinam
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 3 countries.

Ingvild VikDepartment of General Practice, Antibiotic Centre for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway ingvild.vik@medisin.uio.no.ORCID 0000-0002-8947-2914
Ibrahimu MdalaGeneral Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.
Marianne BollestadDepartment of General Practice, Antibiotic Centre for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway.
Gloria Cristina CordobaSection of General Practice and Research Unit of General Practice, Department of Public Health, University of Copenhagen, København, Denmark.ORCID 0000-0002-2609-0468
Lars BjerrumSection of General Practice and Research Unit of General Practice, Department of Public Health, University of Copenhagen, København, Denmark.
Thomas NeumarkPrimary Health Care and Planning Division, Kalmar County Council, Kalmar, Sweden.
Eivind DamsgaardBergen Accident and Emergency Department, Bergen Kommune, Bergen, Norway.
Anders BærheimDepartment of Global Public Health and Primary Care, University of Bergen, Bergen, Hordaland, Norway.
Nils GrudeDepartment of General Practice, Antibiotic Centre for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway.
Morten LindbaekDepartment of General Practice, Antibiotic Centre for Primary Care, Institute of Health and Society, University of Oslo, Oslo, Norway.
University of Oslo · NOUniversity of Copenhagen · DKBergen Kommune · NOLandstinget i Kalmar län · SEUniversity of Bergen · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo 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).

setting16 sites in a primary care setting in Norway, Sweden and Denmark.

participantsData from 181 non-pregnant women aged 18-60 presenting with symptoms of uncomplicated UTI, initially treated with ibuprofen.

methodsUsing 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.

resultsOf 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).

conclusionWe 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).

Indexed as

AdolescentAdultAnti-Bacterial AgentsDenmarkFemaleHumansIbuprofenMiddle AgedNorwaySwedenUrinary Tract InfectionsYoung AdultAnti-Bacterial AgentsIbuprofenantibioticsibuprofenprediction modelprimary careurinary tract infections

Identifiers

PMID32868350
PMCPMC7462246
OpenAlexW3081877788

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.