Exposure to suppressive antibiotic therapy in women with recurrent urinary tract infections and severity of infections : a retrospective population-based cohort study
Llor, Carl (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Ouchi, Dan (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Fernández-García, Silvia (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Giner-Soriano, Maria (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Moragas, Ana (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Morros, Rosa (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Universitat Autònoma de Barcelona

Date:	2025
Abstract:	Women with recurrent urinary tract infections (UTIs) often undergo intensive antibiotic exposure, especially with suppressive therapies. Suppressive therapy is recommended for women with three UTIs in the past year or two in the last 6 months. However, the collateral long-term effects of this have been poorly studied. To assess whether suppressive therapy for recurrent UTIs increases the incidence and severity of future infections compared with episodic UTI treatment. Retrospective cohort study. The study was conducted using data from the Information System for Research in Primary Care database, including 5. 8 million people in Catalonia. Two groups of women with recurrent UTIs (≥3 episodes/year) were compared: those on suppressive antibiotic therapy for ≥6 months and those treated episodically. Primary outcomes were hospitalisations due to pyelonephritis, septicaemia, COVID-19, influenza, pneumonia and mortality by these infections, over a 100-month follow-up period. Among 36 170 women, 2898 (8%) were treated with continuous suppressive therapy. Overall, 6. 9% of the population experienced severe infections, with a higher incidence in women on suppressive therapy (12. 6%) compared with those without (6. 4%), with a HR of 1. 50 (95% CI 1. 33 to 1. 68). Pyelonephritis presented the greatest difference (HR, 1. 95 (95% CI 1. 64 to 2. 33)), followed by septicaemia (HR, 1. 34 (95% CI 1. 13 to 1. 59)) and COVID-19 (HR 1. 23 (95% CI 1. 01 to 1. 50)). Suppressive antibiotic therapy in women with recurrent UTIs is associated with a higher incidence and severity of future infections. Future research should focus on clarifying causal relationships and identifying the potential mechanisms involved.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Urinary tract infections ; COVID-19 ; Anti-Bacterial Agents ; Prognosis
Published in:	BMJ open, Vol. 15 (august 2025) , ISSN 2044-6055

DOI: 10.1136/bmjopen-2024-098371
PMID: 40819861

9 p, 1.0 MB

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