{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T15:55:33Z","timestamp":1762790133081,"version":"build-2065373602"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T00:00:00Z","timestamp":1762732800000},"content-version":"vor","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/T005408\/1"],"award-info":[{"award-number":["MR\/T005408\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100023699","name":"Health Data Research UK","doi-asserted-by":"publisher","award":["CF0129"],"award-info":[{"award-number":["CF0129"]}],"id":[{"id":"10.13039\/501100023699","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000883","name":"University of Bristol","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000883","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We applied an escalation antibiogram to community urine data to assess how presumptive resistance to first-line antibiotics for cystitis affects resistance to antibiotics used to treat pyelonephritis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We extracted susceptibility data from Escherichia coli isolates grown from urine samples from general practice during a 5 year period (2019\u20132023) in a region served by three NHS hospital trusts. Female patients over 18\u2005years old were included, giving a total of 130\u200a514 isolates. We applied a Bayesian model to estimate antibiotic resistance rates for oral pyelonephritis antibiotics, when presuming resistance to each of the first-line antibiotics used for cystitis. The model estimates the probability of resistance with 95% credible intervals and was applied to a variety of patient groups based on age and history of recurrent urinary tract infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Resistance to cystitis antibiotics has a marked effect on the probability of resistance to oral antibiotics used to treat pyelonephritis. In particular, amoxicillin\/clavulanate should be avoided for pyelonephritis if resistance to pivmecillinam is presumed, because predicted resistance rates exceed 50%. For patients with presumed resistance to nitrofurantoin or trimethoprim, the optimal pyelonephritis antibiotic depends on both age group and history of past infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Analysis using an escalation antibiogram informed by our Bayesian model is a useful tool to support empirical antibiotic prescribing for pyelonephritis. It provides an estimate of local resistance rates and a comparison of antibiotic options with a measure of the uncertainty in the data.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jacamr\/dlaf204","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T15:53:08Z","timestamp":1762789988000},"source":"Crossref","is-referenced-by-count":0,"title":["Co-resistance between oral antibiotics for pyelonephritis and those for cystitis\u2014applying an escalation antibiogram model to local community data"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1900-3706","authenticated-orcid":false,"given":"Philip","family":"Williams","sequence":"first","affiliation":[{"name":"School of Cellular and Molecular Medicine, Faculty of Life Sciences, University of Bristol , Bristol ,","place":["UK"]},{"name":"University Hospitals Bristol and Weston NHS Foundation Trust, Bristol Royal Infirmary , Bristol ,","place":["UK"]},{"name":"UK Health Security Agency, Severn Pathology, Bristol ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Barton","sequence":"additional","affiliation":[{"name":"University Hospitals Bristol and Weston NHS Foundation Trust, Bristol Royal Infirmary , Bristol ,","place":["UK"]},{"name":"UK Health Security Agency, Severn Pathology, Bristol ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ranjeet","family":"Bhamber","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol , Bristol ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00e9o","family":"Gorman","sequence":"additional","affiliation":[{"name":"Jean Golding Institute, University of Bristol , Bristol ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew W","family":"Dowsey","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, Bristol Medical School, Faculty of Health Sciences, University of Bristol , Bristol ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1454-8440","authenticated-orcid":false,"given":"Matthew B","family":"Avison","sequence":"additional","affiliation":[{"name":"School of Cellular and Molecular Medicine, Faculty of Life Sciences, University of Bristol , Bristol ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,11,10]]},"reference":[{"key":"2025111010530124400_dlaf204-B1","author":"BMJ Best Practice"},{"key":"2025111010530124400_dlaf204-B2","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.jinf.2008.12.009.19195714","article-title":"Antibiotics versus placebo in the treatment of women with uncomplicated cystitis: a 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