For US Healthcare Professionals
For US HCPs
Understand the Risk Factors for uUTI Treatment Failure and Its Impact on Healthcare Utilization
Treatment failure in uncomplicated UTIs can cause an impactful economic burden.1,2 Some of your members may be at greater risk of failing initial treatment based on their clinical history.3
In two studies*,† of ~614,000 female outpatients with uncomplicated UTIs‡ treated with empirically prescribed oral antibiotics:
Treatment failure was defined as an infection requiring additional clinical intervention§ within 28 days of initial treatment1-3
Do you know the clinical characteristics that increase the risk of future treatment failure?
- *
Based on data from a retrospective cohort study (N=238,335) that used Optum Clinformatics Data Mart Dataset to assess female outpatients aged ≥18 with uUTI empirically treated with oral ABX between October 2015 and September 2021. This study found that 12.3% of patients had evidence of TF.1
- †
Based on data from a retrospective cohort study (N=376,004) that used Optum EHR data to assess female outpatients aged ≥12 with uUTI empirically treated with oral ABX between January 2017 and September 2022. This study found that 16.7% of patients had evidence of TF.2,3
- ‡
Patients with an uncomplicated UTI had a documented uUTI diagnosis code (ICD-10-CM: N30.00, N30.01, N30.9, or N39.0) in an outpatient ambulatory/emergency department setting and no evidence of a complicated UTI.1-3
- §
Additional clinical intervention may have included a second oral ABX prescription, administration of intravenous ABX, or an ED visit or inpatient stay with a new primary diagnosis of UTI.1-3
- ABX=antibiotic; ED=emergency department; EHR=electronic health record; ICD-10-CM=International Classification of Diseases, Tenth Edition, Clinical Modification; TF=treatment failure; UTI=urinary tract infection; uUTI=uncomplicated urinary tract infection.
Clinical characteristics identified as risk factors for treatment failure included women with a history of 3:
- Recurrent uUTIs
- Prior antibiotic use
Recurrent uUTIs||
in patients with recurrent UTIs within the past 12 months vs those without recurrence (95% CI: 1.10-1.14)3
In the study, an estimated 18% of uncomplicated UTI patients were recurrent3
The most commonly recognized definition of recurrence is4:
at least two UTIs occurring in 6 months, or
at least three UTIs occurring in 12 months
Prior Antibiotic Use¶
with 1 previous antibiotic
with 2 previous antibiotics
with 3 previous antibiotics
used for any condition within the past 12 months vs no previous antibiotics (95% CI: 1.11-1.16; 1.23-1.29; 1.56-1.64)3
- ||
Defined as a diagnosis of recurrent UTI, identified in clinician notes, or as two UTIs in the past 6 months or three UTIs in the past 12 months, including the index uUTI diagnosis.3
- ¶
During the 12-month baseline period, not including the index date, the date of the first empirically prescribed oral antibiotic ± 5 days of a randomly selected uUTI diagnosis.3
- CI=confidence interval; UTI=urinary tract infection; uUTI=uncomplicated urinary tract infection.
The healthcare burden of uncomplicated UTIs can be significantly higher when patients experience treatment failure.1,2
higher adjusted rate# of UTI-related ED visits in patients with uUTI treatment failure vs those without2,**
mean increase in average uUTI-related costs†† per patient with treatment failure vs without ($1133 vs $276; P<0.0001)1
Mean (SD) uUTI-related costs per patient
- #
Adjusted rate ratios were estimated from multivariable generalized linear models with negative binomial distribution to account for overdispersion and adjusting for demographics as well as clinical characteristics with a standardized difference >20% between the TF cohort and the no TF cohort.2
- **
UTI-related ED visits: TF, 23.3% (14,656/62,873); no TF, 15.8% (49,518/313,131).2
- ††
uUTI-related costs were defined as treatment for patients with a uUTI diagnosis during the 28-day uUTI episode and included: inpatient stay costs, outpatient costs, and prescription costs.1
- ED=emergency department; EHR=electronic health record; HCRU=healthcare resource utilization; SD=standard deviation; TF=treatment failure; UTI=urinary tract infection; uUTI=uncomplicated urinary tract infection.
References
Franklin M, Emden M, Kautz S, et al. Poster 2839 presented at: IDWeek 2023; October 11-15, 2023; Boston, MA.
Fromer DL, Luck M, Mahendran M, et al. Abstract 215900. Presented at: IDWeek 2024; October 16–19, 2024; Los Angeles, CA.
Fromer DL, Luck ME, Cheng WY, et al. Risk Factors for Empiric Treatment Failure in US Female Outpatients with Uncomplicated Urinary Tract Infection: an Observational Study. J Gen Intern Med. Published online October 2, 2024. doi:10.1007/s11606-024-09029-6
Anger J, Lee U, Ackerman AL, et al. Recurrent uncomplicated urinary tract infections in women: AUA/CUA/SUFU Guideline. J Urol. 2019;202(2);282-289. doi:10.1097/JU.0000000000000296