{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T21:54:22Z","timestamp":1784584462541,"version":"3.55.0"},"reference-count":33,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T00:00:00Z","timestamp":1665532800000},"content-version":"unspecified","delay-in-days":284,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASHE"],"published-print":{"date-parts":[[2022]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S2732494X22002856_as1\">\n\t    <jats:title>Objective:<\/jats:title>\n\t    <jats:p>To conduct a contemporary detailed assessment of outpatient antibiotic prescribing and outcomes for positive urine cultures in a mixed-sex cohort.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X22002856_as2\">\n\t    <jats:title>Design:<\/jats:title>\n\t    <jats:p>Multicenter retrospective cohort review.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X22002856_as3\">\n\t    <jats:title>Setting:<\/jats:title>\n\t    <jats:p>The study was conducted using data from 31 Veterans\u2019 Affairs medical centers.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X22002856_as4\">\n\t    <jats:title>Patients:<\/jats:title>\n\t    <jats:p>Outpatient adults with positive urine cultures.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X22002856_as5\">\n\t    <jats:title>Methods:<\/jats:title>\n\t    <jats:p>From 2016 to 2019, data were extracted through a nationwide database and manual chart review. Positive urine cultures were reviewed at the chart, clinician, and aggregate levels. Cases were classified as cystitis, pyelonephritis, or asymptomatic bacteriuria (ASB) based upon documented signs and symptoms. Preferred therapy definitions were applied for subdiagnoses: ASB (no antibiotics), cystitis (trimethoprim-sulfamethoxazole, nitrofurantoin, \u03b2-lactams), and pyelonephritis (trimethoprim-sulfamethoxazole, fluoroquinolone). Outcomes included 30-day clinical failure or hospitalization. Odds ratios for outcomes between treatments were estimated using logistic regression.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X22002856_as6\">\n\t    <jats:title>Results:<\/jats:title>\n\t    <jats:p>Of 3,255 cases reviewed, ASB was identified in 1,628 cases (50%), cystitis was identified in 1,156 cases (36%), and pyelonephritis was identified in 471 cases (15%). Of all 2,831 cases, 1,298 (46%) received preferred therapy selection and duration for cases where it could be defined. The most common antibiotic class prescribed was a fluoroquinolone (34%). Patients prescribed preferred therapy had lower odds of clinical failure: preferred (8%) versus nonpreferred (10%) (unadjusted OR, 0.74; 95% confidence interval [CI], 0.58\u20130.95; <jats:italic>P<\/jats:italic> = .018). They also had lower odds of 30-day hospitalization: preferred therapy (3%) versus nonpreferred therapy (5%) (unadjusted OR, 0.55; 95% CI, 0.37\u20130.81; <jats:italic>P<\/jats:italic> = .002). Odds of clinical treatment failure or hospitalization was higher for \u03b2-lactams relative to ciprofloxacin (unadjusted OR, 1.89; 95% CI, 1.23\u20132.90; <jats:italic>P<\/jats:italic> = .002).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X22002856_as7\">\n\t    <jats:title>Conclusions:<\/jats:title>\n\t    <jats:p>Clinicians prescribed preferred therapy 46% of the time. Those prescribed preferred therapy had lower odds of clinical failure and of being hospitalized.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/ash.2022.285","type":"journal-article","created":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T04:52:12Z","timestamp":1665636732000},"source":"Crossref","is-referenced-by-count":8,"title":["Outpatient treatment and clinical outcomes of bacteriuria in veterans: A retrospective cohort analysis"],"prefix":"10.1017","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5569-7576","authenticated-orcid":false,"given":"Suzette A.","family":"Rovelsky","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0795-1688","authenticated-orcid":false,"given":"Michelle","family":"Vu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9339-5392","authenticated-orcid":false,"given":"Alexis K.","family":"Barrett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Bukowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangming","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muriel","family":"Burk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Echevarria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie J","family":"Suda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Cunningham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9933-4120","authenticated-orcid":false,"given":"Karl J","family":"Madaras-Kelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the UTI Management Improvement Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2022,10,12]]},"reference":[{"key":"S2732494X22002856_ref15","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix474"},{"key":"S2732494X22002856_ref1","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofw281"},{"key":"S2732494X22002856_ref2","unstructured":"2. Antibiotic resistance threats in the United States, 2019. Centers for Disease Control and Prevention website. https:\/\/www.cdc.gov\/drugresistance\/pdf\/threats-report\/2019-ar-threats-report-508.pdf. Published 2019. Accessed September 19, 2022."},{"key":"S2732494X22002856_ref9","unstructured":"9. Hooton, TM. Acute simple cystitis in men. UpToDate website. https:\/\/www.uptodate.com\/contents\/acute-simple-cystitis-in-men. Updated July 20, 2020. Accessed June 22, 2021."},{"key":"S2732494X22002856_ref24","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis947"},{"key":"S2732494X22002856_ref31","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00151-21"},{"key":"S2732494X22002856_ref10","unstructured":"10. Hooton, TM , Gupta, K. Acute complicated urinary tract infection (including pyelonephritis) in adults. UpToDate website. https:\/\/www.uptodate.com\/contents\/acute-complicated-urinary-tract-infection-including-pyelonephritis-in-adults. Updated March 19, 2021. 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