Programme no. 337-OP
Does non-antibiotic treatment of urinary tract infections increase the rate of recurrences and severe complications? Results of a long-term-follow up.
Jutta Bleidorn*1, Karl Wegscheider2, Guido Schmiemann3, Eva Hummers-Pradier4, Ildikó Gágyor5
1Department of General Practice,Medical School Hanover,Hannover,Germany, 2Department of Medical Biometry and Epidemiology,University Medical Centre Hamburg-Eppendorf,Hamburg,Germany, 3 Institute for Public Health and Nursing Science,University of Bremen,Bremen,Germany, 4Department of General Practice,University Medical Center Göttingen,Göttingen,Germany, 5Department of General Practice,University Medical Center Göttingen,Göttingen,Germany
* = Presenting author
Objectives: To assess whether symptomatic treatment of UTI increases recurrence rate and complications in the long-term follow up.
Urinary tract infections are common in general practice and usually treated with antibiotics as recommended by guidelines, though UTI are known to be harmless and often self-limited. With the trial ICUTI (Immediate vs. conditional antibiotic treatment for UTI) we assessed whether antibiotic prescriptions can be reduced by initial symptomatic treatment (antibiotics only if needed), without negative effects on symptom course and complications.
Results: Preliminary results show that after four weeks 5.8% (Ibuprofen) versus 11.1% (Fosfomycin) of patients reported recurrent UTI, whereas pyelonephritis occurred more frequently in the Ibuprofen-group (n=5 vs. n=1, not significant). In the 6-month-follow-up data from 386/494 women could be collected. Full analysis of these data will take place until 4/ 2015 after follow up will be completed.
Material/Methods: With the double-blind randomised controlled UTI trial ICUTI, we compared a) initial treatment with ibuprofen and antibiotics only if needed with b) immediate antibiotic treatment with fosfomycin. From February 2012 until February 2014, 494 women were included. Follow up calls were conducted to assess symptoms, recurrences and complications (pyelonephritis, urosepsis) during the first week and after four weeks, six and twelve months after trial participation. Data were analysed by group comparison.
Conclusion: If the rate of recurrences in the long-term follow up of ICUTI is comparable between symptomatic and antibiotic treatment of the index UTI, results will form a basis to discuss symptomatic treatment of UTI with affected women.
Points for discussion: Is there a considerable health risk when treating UTI symptomatically?