Evidence map›Paper›PMID 38869841›Full record

ArticleInfectious diseases and therapy2024

Treatment Patterns and Adherence to Guidelines for Uncomplicated Urinary Tract Infection in Germany: A Retrospective Cohort Study.

Axel Krinner, Michael Schultze, Alen Marijam, Marc Pignot, Nils Kossack, Fanny S Mitrani-Gold, Ashish V Joshi

Abstract read
In one paragraph

Article in Infectious diseases and therapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  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

7 authors.

Axel KrinnerWIG2 GmbH Scientific Institute for Health Economics and Health System Research, Leipzig, Germany.ORCID http://orcid.org/0009-0001-7285-0448
Michael SchultzeZEG - Berlin Center for Epidemiology and Health Research GmbH, Berlin, Germany.
Alen MarijamGSK, 1250 S Collegeville Rd, Collegeville, PA, 19426, US.ORCID http://orcid.org/0000-0003-1046-9702
Marc PignotZEG - Berlin Center for Epidemiology and Health Research GmbH, Berlin, Germany.ORCID http://orcid.org/0000-0002-1883-4113
Nils KossackWIG2 GmbH Scientific Institute for Health Economics and Health System Research, Leipzig, Germany.ORCID http://orcid.org/0000-0002-9521-3898
Fanny S Mitrani-GoldGSK, 1250 S Collegeville Rd, Collegeville, PA, 19426, US.ORCID http://orcid.org/0000-0001-8829-7088
Ashish V JoshiGSK, 1250 S Collegeville Rd, Collegeville, PA, 19426, US. ashish.2.joshi@gsk.com.ORCID http://orcid.org/0000-0002-7089-1545

Funding

GlaxoSmithKline (GB) Study number 214846
6 · The paper itself

Abstract

introductionUnderstanding antibiotic prescribing for uncomplicated urinary tract infection (uUTI) could help to optimize management. However, data on uUTI treatment patterns in the European Union are scarce. We used real-world data to evaluate adherence to antibiotic prescribing guidelines for femalepatients with uUTI in Germany.

methodsThis retrospective cohort study used anonymized German statutory health insurance claims data from the Wissenschaftliches Institut für Gesundheitsökonomie und Gesundheitssystemforschung from January 2013 to December 2019. Patients were female, aged ≥ 12 years, with an index uUTI diagnosis. Patient characteristics and treating physician specialties were examined overall and in sub-cohorts for recommended/non-recommended treatment (based on initial therapy adherence to German uUTI treatment guidelines) and optimal/sub-optimal outcome (based on a prescription of different antibiotics or a urinary tract infection-related episode).

resultsOverall, 144,645 uUTI cases in 124,971 patients were analyzed; 51,230 (35.4%) and 93,415 (64.6%) cases were assigned to the recommended/non-recommended treatment sub-cohorts, respectively. Clinically meaningful differences in age and comorbidities were observed between these sub-cohorts. Most cases had an optimal outcome (n = 122,823; 84.9%); of these, a higher proportion received antibiotics that were recommended but not as first-choice versus first-choice therapies as their initial treatment (58.6% vs. 35.3%). In the sub-optimal outcome cohort, 49.1% received antibiotics that were recommended but not as first-choice and 41.1% received first-choice therapies as their initial treatment. Most uUTIs were treated by general practitioners (GPs; 82.3%), followed by gynecologists (13.3%), and urologists (6.8%). Notably, 64.5% of initial therapy prescriptions filled by gynecologists and 32.1% by GPs were first-choice antibiotics.

conclusionA high proportion of prescribed treatments for the initial uUTI episode were not recommended by German uUTI guidelines as first-choice antibiotics. Prescribing adherence varied by physician specialty; specialists showed greater adherence to treatment guidelines versus GPs. This study provides a novel and multi-dimensional picture of uUTI treatment in Germany.

Indexed as

Adherence to guidelinesAntibioticsAntimicrobialsPhysician prescribingTreatment patternsUrinary tract infections

Identifiers

PMID38869841
PMCPMC11219654

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.