{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T23:38:50Z","timestamp":1785541130123,"version":"3.56.0"},"reference-count":30,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"unspecified","delay-in-days":212,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ASHE"],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S2732494X23001766_as1\">\n\t    <jats:title>Background:<\/jats:title>\n\t    <jats:p>We sought to evaluate the impact of antibiotic selection and duration of therapy on treatment failure in older adults with catheter-associated urinary tract infection (CA-UTI).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X23001766_as2\">\n\t    <jats:title>Methods:<\/jats:title>\n\t    <jats:p>We conducted a population-based cohort study comparing antibiotic treatment options and duration of therapy for non-hospitalized adults aged 66 and older with presumed CA-UTI (defined as an antibiotic prescription and an organism identified in urine culture in a patient with urinary catheterization documented within the prior 90 d). The primary outcome was treatment failure, a composite of repeat urinary antibiotic prescribing, positive blood culture with the same organism, all-cause hospitalization or mortality, within 60 days. We determined the risk of treatment failure accounting for age, sex, comorbidities, and healthcare exposure using log-binomial regression.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X23001766_as3\">\n\t    <jats:title>Results:<\/jats:title>\n\t    <jats:p>Of 4,436 CA-UTI patients, 2,709 (61.1%) experienced treatment failure. Compared to a reference of TMP-SMX (61.9% failure), of those treated with fluoroquinolones, 56.3% experienced failure (RR 0.91, 95% CI: 0.85\u20130.98) and 60.9% of patients treated with nitrofurantoin experienced failure (RR 1.02, 95% CI: 0.94\u20131.10). Compared to 5\u20137 days of therapy (treatment failure: 59.4%), 1\u20134 days was associated with 69.5% failure (RR 1.15, 95% CI: 1.05\u20131.27), and 8\u201314 days was associated with a 62.0% failure (RR 1.05, 95% CI: 0.99\u20131.11).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2732494X23001766_as4\">\n\t    <jats:title>Conclusions:<\/jats:title>\n\t    <jats:p>Although most treatment options for CA-UTI have a similar risk of treatment failure, fluoroquinolones, and treatment durations \u2265 5 days in duration appear to be associated with modestly improved clinical outcomes. From a duration of therapy perspective, this study provides reassurance that relatively short courses of 5\u20137 days may be reasonable for CA-UTI.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/ash.2023.176","type":"journal-article","created":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T08:21:56Z","timestamp":1690878116000},"source":"Crossref","is-referenced-by-count":11,"title":["Antibiotic Selection and Duration for Catheter-Associated Urinary Tract Infection in Non-Hospitalized Older Adults: A Population-Based Cohort Study"],"prefix":"10.1017","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5467-6776","authenticated-orcid":false,"given":"Bradley J.","family":"Langford","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Daneman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Diong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1162-8744","authenticated-orcid":false,"given":"Samantha M.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2516-9967","authenticated-orcid":false,"given":"Daniel J.","family":"Fridman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennie","family":"Johnstone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek","family":"MacFadden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8228-9095","authenticated-orcid":false,"given":"Kwadwo","family":"Mponponsuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir N.","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin L.","family":"Schwartz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin A.","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2023,8,1]]},"reference":[{"key":"S2732494X23001766_ref5","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2016.266"},{"key":"S2732494X23001766_ref6","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2012-001774"},{"key":"S2732494X23001766_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2019.10.016"},{"key":"S2732494X23001766_ref21","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD007182.pub2"},{"key":"S2732494X23001766_ref16","first-page":"1331","article-title":"Variability in Antibiotic use across nursing homes and the risk of antibiotic-related adverse outcomes for individual residents","volume":"175","author":"Daneman","year":"2015","journal-title":"JAMA InternMed"},{"key":"S2732494X23001766_ref29","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.150067"},{"key":"S2732494X23001766_ref15","first-page":"67","article-title":"Coding accuracy of administrative drug claims in the Ontario Drug Benefit database","volume":"10","author":"Levy","year":"2003","journal-title":"Can J Clin Pharmacol."},{"key":"S2732494X23001766_ref24","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.383"},{"key":"S2732494X23001766_ref11","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000822"},{"key":"S2732494X23001766_ref1","doi-asserted-by":"publisher","DOI":"10.1186\/2047-2994-3-23"},{"key":"S2732494X23001766_ref9","doi-asserted-by":"publisher","DOI":"10.1086\/650482"},{"key":"S2732494X23001766_ref7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1504906"},{"key":"S2732494X23001766_ref14","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20210215"},{"key":"S2732494X23001766_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2013.09.003"},{"key":"S2732494X23001766_ref23","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-010077"},{"key":"S2732494X23001766_ref10","unstructured":"10. 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Urinary tract infection (catheter-associated): antimicrobial prescribing, 2018. https:\/\/www.nice.org.uk\/guidance\/ng113."},{"key":"S2732494X23001766_ref3","doi-asserted-by":"publisher","DOI":"10.1086\/502502"},{"key":"S2732494X23001766_ref22","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz021"},{"key":"S2732494X23001766_ref19","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciab256"},{"key":"S2732494X23001766_ref28","doi-asserted-by":"publisher","DOI":"10.1159\/000472872"},{"key":"S2732494X23001766_ref18","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2020.1256"},{"key":"S2732494X23001766_ref17","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciab116"},{"key":"S2732494X23001766_ref8","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.1878"},{"key":"S2732494X23001766_ref4","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16256"},{"key":"S2732494X23001766_ref26","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa124"},{"key":"S2732494X23001766_ref25","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000846"},{"key":"S2732494X23001766_ref30","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-019-03027-8"},{"key":"S2732494X23001766_ref27","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30676-5"},{"key":"S2732494X23001766_ref12","doi-asserted-by":"publisher","DOI":"10.1185\/030079907X233340"},{"key":"S2732494X23001766_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/S1525-8610(04)70459-4"}],"container-title":["Antimicrobial Stewardship &amp; Healthcare Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2732494X23001766","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T08:22:05Z","timestamp":1690878125000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2732494X23001766\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023]]}},"alternative-id":["S2732494X23001766"],"URL":"https:\/\/doi.org\/10.1017\/ash.2023.176","relation":{},"ISSN":["2732-494X"],"issn-type":[{"value":"2732-494X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023]]},"article-number":"e132"}}