Community study on the effect of antibiotic use for urinary tract infections on the emergence and spread of resistance

Not Applicable

Completed

• Conditions: rinary tract infection (UTI); antimicrobial resistance (AMR); Urological and Genital Diseases; Other disorders of urinary system

• Registration Number: ISRCTN26797709
• Lead Sponsor: niversity of Geneva Hospitals (Switzerland)

Brief Summary

1. 2018 results in https://www.ncbi.nlm.nih.gov/pubmed/29331548 (added 18/01/2019)

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2010-11-24
• Study Completion: 2013-12-31
• Last Update Posted: 11 February 2019

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 1350

Inclusion Criteria

1. Adult patients = 18 years old
2. Presenting with an acute lower or upper, uncomplicated or complicated UTI to the Emergency Room or Outpatient Clinic of the participating GP practices, clinics and hospitals
3. Requiring an antibiotic treatment of at least one dose
4. No antibiotics taken within the last 30 days
5. At least one other person living in the patient's household, defined as a person who spends at least three nights per week in the same house or apartment
6. Informed consent to the study participation

Household members (maximum 3) of the index patients will also be invited to participate. Control patients will be recruited from patients (and their household contacts) presenting either with minor trauma or for a gynaecologic exam to the GPs? / outpatient clinics.

Exclusion Criteria

1. Refusal to participate
2. Unable to give informed consent
3. Presence of indwelling urinary catheters or urethral pigtail catheters
4. Renal transplant recipients; acute or chronic renal failure requiring dialysis
5. Recent discharge from hospital (during the last 30 days)
6. Treatment with systemic antibiotics within the last 30 days
7. Patients with severe sepsis or septic shock requiring intensive care
8. Permanently institutionalized residents of nursing homes or long term care facilities
9. Follow-up not possible or unlikely to be successful

Study & Design

• Study Type: Observational
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Carriage of antibiotic-resistant E. coli on follow-up cultures (at the end of antibiotic therapy and four weeks after the end of antibiotic therapy), stratified by duration of exposure and choice of antibiotic treatment (including also the causative pathogen of the initial episode of urinary tract infection), as well the baseline resistance prevalence of the index patient and his household members.

Secondary Outcome Measures

Name	Time	Method
<br> 1. The impact of antibiotic therapy duration on carriage of resistant streptococci in the oropharyngeal flora<br> 2. The proportion of susceptible bacteria on follow-up cultures<br>