Demographic, Clinical, and Treatment Parameters Influencing the Outcome of Acute Cystitis
A meta-analysis of six double-blinded clinical trials was undertaken to identify risk factors associated with bacteriologic outcome in 3,108 women with acute cystitis. Eleven antibiotic regimens were used, including ciprofloxacin, ofloxacin, norfloxacin, trimethoprim-sulfamethoxazole, and nitrofuran...
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| Veröffentlicht in: | Clinical infectious diseases 1999-07, Vol.29 (1), p.113-119 |
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| creator | Echols, Roger M. Tosiello, Robert L. Haverstock, Daniel C. Tice, Alan D. |
| description | A meta-analysis of six double-blinded clinical trials was undertaken to identify risk factors associated with bacteriologic outcome in 3,108 women with acute cystitis. Eleven antibiotic regimens were used, including ciprofloxacin, ofloxacin, norfloxacin, trimethoprim-sulfamethoxazole, and nitrofurantoin. Entry criteria for all studies were identical. Among 2,409 patients who were defined to be valid for efficacy analysis, pathogens included Escherichia coli (78.6%), Staphylococcus saprophyticus (4.4%), Klebsiella pneumoniae (4.3%), Proteus mirabilis (3.7%), and “other” (9%). Causative bacteria were eradicated at the end of treatment in 93% of patients. The following parameters were associated with successful bacteriologic outcome: not using a diaphragm (P = .0041), treatment for ⩾3 days (P = .0043), pathogen not “other” (P = .0043), symptom duration of |
| doi_str_mv | 10.1086/520138 |
| format | Article |
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Eleven antibiotic regimens were used, including ciprofloxacin, ofloxacin, norfloxacin, trimethoprim-sulfamethoxazole, and nitrofurantoin. Entry criteria for all studies were identical. Among 2,409 patients who were defined to be valid for efficacy analysis, pathogens included Escherichia coli (78.6%), Staphylococcus saprophyticus (4.4%), Klebsiella pneumoniae (4.3%), Proteus mirabilis (3.7%), and “other” (9%). Causative bacteria were eradicated at the end of treatment in 93% of patients. The following parameters were associated with successful bacteriologic outcome: not using a diaphragm (P = .0041), treatment for ⩾3 days (P = .0043), pathogen not “other” (P = .0043), symptom duration of <2 days (P = .0096), and African American race (P = .0147). K. pneumoniae (P = .0496) and “other” pathogens (P = .0018) were associated with increased probability of bacteriologic treatment failure. The presence of pyuria (⩾10 WBCs per high-power field) did not correlate with outcome and was inversely correlated with the finding of ⩾105 bacterial colony-forming units per mL of urine (P < .001). This large database identifies new parameters associated with treatment outcomes of acute cystitis and calls into question current clinical trial guidelines.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1086/520138</identifier><identifier>PMID: 10433573</identifier><identifier>CODEN: CIDIEL</identifier><language>eng</language><publisher>Chicago, IL: The University of Chicago Press</publisher><subject>Acute Disease ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents - therapeutic use ; Antimicrobials ; Bacterial diseases ; Bacterial diseases of the urinary system ; Bacteriuria ; Biological and medical sciences ; Clinical Articles ; Clinical trials ; Colony Count, Microbial ; Cystitis ; Cystitis - drug therapy ; Cystitis - microbiology ; Experimentation ; Female ; Guidelines as Topic ; Health outcomes ; Human bacterial diseases ; Humans ; Infectious diseases ; Medical sciences ; Middle Aged ; Outcome and Process Assessment (Health Care) ; Pathogens ; Prognosis ; Pyuria ; United States ; United States Food and Drug Administration ; Urinary tract infections ; Urine</subject><ispartof>Clinical infectious diseases, 1999-07, Vol.29 (1), p.113-119</ispartof><rights>Copyright 1999 The Infectious Diseases Society of America</rights><rights>1999 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c461t-ae37b3006edcd80cfdba18d0b83452a3162472fb37569ff0d89c7f43b855952e3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/4481932$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/4481932$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>310,311,315,781,785,790,791,804,23932,23933,25142,27926,27927,58019,58252</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1873711$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10433573$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Echols, Roger M.</creatorcontrib><creatorcontrib>Tosiello, Robert L.</creatorcontrib><creatorcontrib>Haverstock, Daniel C.</creatorcontrib><creatorcontrib>Tice, Alan D.</creatorcontrib><title>Demographic, Clinical, and Treatment Parameters Influencing the Outcome of Acute Cystitis</title><title>Clinical infectious diseases</title><addtitle>Clinical Infectious Diseases</addtitle><description>A meta-analysis of six double-blinded clinical trials was undertaken to identify risk factors associated with bacteriologic outcome in 3,108 women with acute cystitis. Eleven antibiotic regimens were used, including ciprofloxacin, ofloxacin, norfloxacin, trimethoprim-sulfamethoxazole, and nitrofurantoin. Entry criteria for all studies were identical. Among 2,409 patients who were defined to be valid for efficacy analysis, pathogens included Escherichia coli (78.6%), Staphylococcus saprophyticus (4.4%), Klebsiella pneumoniae (4.3%), Proteus mirabilis (3.7%), and “other” (9%). Causative bacteria were eradicated at the end of treatment in 93% of patients. The following parameters were associated with successful bacteriologic outcome: not using a diaphragm (P = .0041), treatment for ⩾3 days (P = .0043), pathogen not “other” (P = .0043), symptom duration of <2 days (P = .0096), and African American race (P = .0147). K. pneumoniae (P = .0496) and “other” pathogens (P = .0018) were associated with increased probability of bacteriologic treatment failure. The presence of pyuria (⩾10 WBCs per high-power field) did not correlate with outcome and was inversely correlated with the finding of ⩾105 bacterial colony-forming units per mL of urine (P < .001). This large database identifies new parameters associated with treatment outcomes of acute cystitis and calls into question current clinical trial guidelines.</description><subject>Acute Disease</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antimicrobials</subject><subject>Bacterial diseases</subject><subject>Bacterial diseases of the urinary system</subject><subject>Bacteriuria</subject><subject>Biological and medical sciences</subject><subject>Clinical Articles</subject><subject>Clinical trials</subject><subject>Colony Count, Microbial</subject><subject>Cystitis</subject><subject>Cystitis - drug therapy</subject><subject>Cystitis - microbiology</subject><subject>Experimentation</subject><subject>Female</subject><subject>Guidelines as Topic</subject><subject>Health outcomes</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Outcome and Process Assessment (Health Care)</subject><subject>Pathogens</subject><subject>Prognosis</subject><subject>Pyuria</subject><subject>United States</subject><subject>United States Food and Drug Administration</subject><subject>Urinary tract infections</subject><subject>Urine</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkFtLHTEURkOp1EvrL5CSB_HJsblP5lGOlyOICrW09SVkMjsaO5djkgH9947MQfu0N6zF97AQ2qXkiBKtfkhGKNef0BaVvCyUrOjn6SdSF0JzvYm2U3okhFJN5Be0SYngXJZ8C_09gW64j3b1ENwhXrShD862h9j2Db6NYHMHfcY3NtoOMsSEL3rfjtC70N_j_AD4esxu6AAPHh-7MQNevKQcckhf0Ya3bYJv67uDfp2d3i6WxeX1-cXi-LJwQtFcWOBlzQlR0LhGE-eb2lLdkFpzIZnlVDFRMl_zUqrKe9LoypVe8FpLWUkGfAcdzLurODyNkLLpQnLQtraHYUxGVZVghKkP0cUhpQjerGLobHwxlJi3iGaOOInf14tj3UHznzZXm4T9tWDTVMtHO_VIH54ueUnppO3N2mPKQ3zHQmhacTbhYsYhZXh-xzb-M2oakGb5585cLe8YPSe_zU_-Ci6SkDI</recordid><startdate>19990701</startdate><enddate>19990701</enddate><creator>Echols, Roger M.</creator><creator>Tosiello, Robert L.</creator><creator>Haverstock, Daniel C.</creator><creator>Tice, Alan D.</creator><general>The University of Chicago Press</general><general>University of Chicago Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19990701</creationdate><title>Demographic, Clinical, and Treatment Parameters Influencing the Outcome of Acute Cystitis</title><author>Echols, Roger M. ; Tosiello, Robert L. ; Haverstock, Daniel C. ; Tice, Alan D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c461t-ae37b3006edcd80cfdba18d0b83452a3162472fb37569ff0d89c7f43b855952e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Acute Disease</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antimicrobials</topic><topic>Bacterial diseases</topic><topic>Bacterial diseases of the urinary system</topic><topic>Bacteriuria</topic><topic>Biological and medical sciences</topic><topic>Clinical Articles</topic><topic>Clinical trials</topic><topic>Colony Count, Microbial</topic><topic>Cystitis</topic><topic>Cystitis - drug therapy</topic><topic>Cystitis - microbiology</topic><topic>Experimentation</topic><topic>Female</topic><topic>Guidelines as Topic</topic><topic>Health outcomes</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Outcome and Process Assessment (Health Care)</topic><topic>Pathogens</topic><topic>Prognosis</topic><topic>Pyuria</topic><topic>United States</topic><topic>United States Food and Drug Administration</topic><topic>Urinary tract infections</topic><topic>Urine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Echols, Roger M.</creatorcontrib><creatorcontrib>Tosiello, Robert L.</creatorcontrib><creatorcontrib>Haverstock, Daniel C.</creatorcontrib><creatorcontrib>Tice, Alan D.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Echols, Roger M.</au><au>Tosiello, Robert L.</au><au>Haverstock, Daniel C.</au><au>Tice, Alan D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Demographic, Clinical, and Treatment Parameters Influencing the Outcome of Acute Cystitis</atitle><jtitle>Clinical infectious diseases</jtitle><addtitle>Clinical Infectious Diseases</addtitle><date>1999-07-01</date><risdate>1999</risdate><volume>29</volume><issue>1</issue><spage>113</spage><epage>119</epage><pages>113-119</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><coden>CIDIEL</coden><abstract>A meta-analysis of six double-blinded clinical trials was undertaken to identify risk factors associated with bacteriologic outcome in 3,108 women with acute cystitis. Eleven antibiotic regimens were used, including ciprofloxacin, ofloxacin, norfloxacin, trimethoprim-sulfamethoxazole, and nitrofurantoin. Entry criteria for all studies were identical. Among 2,409 patients who were defined to be valid for efficacy analysis, pathogens included Escherichia coli (78.6%), Staphylococcus saprophyticus (4.4%), Klebsiella pneumoniae (4.3%), Proteus mirabilis (3.7%), and “other” (9%). Causative bacteria were eradicated at the end of treatment in 93% of patients. The following parameters were associated with successful bacteriologic outcome: not using a diaphragm (P = .0041), treatment for ⩾3 days (P = .0043), pathogen not “other” (P = .0043), symptom duration of <2 days (P = .0096), and African American race (P = .0147). K. pneumoniae (P = .0496) and “other” pathogens (P = .0018) were associated with increased probability of bacteriologic treatment failure. The presence of pyuria (⩾10 WBCs per high-power field) did not correlate with outcome and was inversely correlated with the finding of ⩾105 bacterial colony-forming units per mL of urine (P < .001). This large database identifies new parameters associated with treatment outcomes of acute cystitis and calls into question current clinical trial guidelines.</abstract><cop>Chicago, IL</cop><pub>The University of Chicago Press</pub><pmid>10433573</pmid><doi>10.1086/520138</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Clinical infectious diseases, 1999-07, Vol.29 (1), p.113-119 |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; JSTOR; EZB Electronic Journals Library |
| subjects | Acute Disease Adolescent Adult Aged Aged, 80 and over Anti-Bacterial Agents - therapeutic use Antimicrobials Bacterial diseases Bacterial diseases of the urinary system Bacteriuria Biological and medical sciences Clinical Articles Clinical trials Colony Count, Microbial Cystitis Cystitis - drug therapy Cystitis - microbiology Experimentation Female Guidelines as Topic Health outcomes Human bacterial diseases Humans Infectious diseases Medical sciences Middle Aged Outcome and Process Assessment (Health Care) Pathogens Prognosis Pyuria United States United States Food and Drug Administration Urinary tract infections Urine |
| title | Demographic, Clinical, and Treatment Parameters Influencing the Outcome of Acute Cystitis |
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