Observational studyJournal of general internal medicine2025
Risk Factors for Empiric Treatment Failure in US Female Outpatients with Uncomplicated Urinary Tract Infection: an Observational Study.
Observational study in Journal of general internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 6 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Definitions and rates of treatment failure in females with uncomplicated urinary tract infection: a systematic literature review.The Journal of antimicrobial chemotherapy · 2026Pooled it
- Pangenome analysis ofAntimicrobial agents and chemotherapy · 2026Article
- Co-resistance between oral antibiotics for pyelonephritis and those for cystitis-applying an escalation antibiogram model to local community data.JAC-antimicrobial resistance · 2025Article
- CAUTIon - not all UTIs are the same.Nature reviews. Urology · 2025Review
- Full Validation of Pooled Antibiotic Susceptibility Testing Using CLSI Methods and Performance Criteria in UTI Pathogens.Antibiotics (Basel, Switzerland) · 2025Article
- Impact of empirical treatment failure on health care resource utilization and costs among female patients with uncomplicated urinary tract infections in a US-based Integrated Health Delivery Network.Journal of managed care & specialty pharmacy · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTreatment failure (TF) in uncomplicated urinary tract infection (uUTI) increases disease burden and risk of antimicrobial resistance. Identification of risk factors for TF could inform empiric treatment decisions and reduce suboptimal outcomes.
objectiveTo evaluate the incidence of TF to empirically prescribed oral antibiotics and identify risk factors for TF in females with uUTI in the United States (US).
designThis retrospective cohort study used Optum's de-identified Electronic Health Record dataset (January 2017-September 2022). PATIENTS: Eligible female patients aged ≥ 12 years had ≥ 1 diagnosis of urinary tract infection (UTI) in an outpatient ambulatory/emergency department (ED) setting, ≥ 1 empiric oral antibiotic prescription, and no evidence of complicated UTI (cUTI). MAIN MEASURES: TF was defined as having a new/repeat oral antibiotic prescription, IV antibiotic administration or acute UTI diagnosis ≤ 28 days following initial empiric oral antibiotic prescription. Risk factors of TF were selected using LASSO and reported using adjusted risk ratios (aRR) and 95% CIs. KEY
resultsOf 376,004 patients with uUTI, 62,873 (16.7%) experienced TF. Incidence of TF was highest in patients with history of antibiotic TF (33.9%) or fosfomycin prescription (30.1%). Significant risk factors of TF included ≥ 3 prior antibiotic prescriptions (aRR [95% CI]: 1.60 [1.56-1.64]); fosfomycin prescription (1.60 [1.38-1.86]); uUTI diagnosis in ED (1.49 [1.46-1.52]), Southern US residence (1.37 [1.35-1.40]), age ≥ 75 years (1.35 [1.29-1.41]), recurrent UTI (1.12 [1.10-1.14]) and obesity (1.06 [1.04-1.08]).
conclusionsIncidence of TF to empirically prescribed oral antibiotics for uUTI is considerable. Prior infections requiring antibiotic prescription and location of care are key risk factors for TF in female outpatients with uUTI. Knowledge of these TF risk factors can inform shared-decision making and supplement existing guidance on uUTI treatment.
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