{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T20:09:27Z","timestamp":1788984567493,"version":"build-2803163510"},"reference-count":14,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T00:00:00Z","timestamp":1668988800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"GSK"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>We evaluated associations between antibiotic prescription and healthcare resource use and costs (Part A), and between antibiotic switching and healthcare resource use, costs, and uncomplicated urinary tract infection recurrence (Part B) in female patients with uncomplicated urinary tract infection in the United States.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This retrospective cohort study of linked Optum and Premier Healthcare Database data included female patients \u226512 years old with an uncomplicated urinary tract infection diagnosis (index date), who were prescribed antibiotics during an outpatient\/emergency department visit between January 1, 2013 and December 31, 2018. In Part A, patients were stratified by antibiotic prescription appropriateness: appropriate and optimal (compliant with Infectious Diseases Society of America 2011 guidelines for drug class\/treatment duration) versus inappropriate\/suboptimal (inappropriate drug class\/treatment duration per Infectious Diseases Society of America 2011 guidelines, and\/or treatment failure). In Part B, patients were stratified by treatment pattern (antibiotic switch vs no antibiotic switch). Healthcare resource use and costs during index episode (within 28 days of index date) and 12-month follow-up were compared.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of 5870 patients (mean age 44.5 years), 2762 (47.1%) had inappropriate\/suboptimal prescriptions and 567 (9.7%) switched antibiotic. Inappropriate\/suboptimal prescriptions were associated with higher healthcare resource use (mean number of ambulatory care and pharmacy claims [both p &lt; 0.001]), and higher total mean cost (inpatient, outpatient\/emergency department, ambulatory visits, and pharmacy costs) per patient ($2616) than appropriate and optimal prescriptions ($649; p &lt; 0.001) (Part A). Antibiotic switching was associated with more pharmacy claims and higher total mean costs (p \u2264 0.01), and a higher incidence of recurrent uncomplicated urinary tract infection (18.9%) than no antibiotic switching (14.2%; p &lt; 0.001) (Part B).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Inappropriate\/suboptimal prescriptions and antibiotic switching were associated with high costs, ambulatory care, and pharmacy claims, suggesting a need for improved uncomplicated urinary tract infection prescribing practices in the United States.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0277713","type":"journal-article","created":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T18:37:15Z","timestamp":1669055835000},"page":"e0277713","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":20,"title":["Treatment patterns, healthcare resource use, and costs associated with uncomplicated urinary tract infection among female patients in the United States"],"prefix":"10.1371","volume":"17","author":[{"given":"Rena C.","family":"Moon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alen","family":"Marijam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8829-7088","authenticated-orcid":true,"given":"Fanny S.","family":"Mitrani-Gold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel C.","family":"Gibbons","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Kartashov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning A.","family":"Rosenthal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7089-1545","authenticated-orcid":true,"given":"Ashish V.","family":"Joshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,11,21]]},"reference":[{"issue":"1","key":"pone.0277713.ref001","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.idc.2013.09.003","article-title":"Urinary tract infection syndromes: occurrence, recurrence, bacteriology, risk factors, and disease burden.","volume":"28","author":"B. Foxman","year":"2014","journal-title":"Infect Dis Clin North Am"},{"key":"pone.0277713.ref002","doi-asserted-by":"crossref","first-page":"1756287219832172","DOI":"10.1177\/1756287219832172","article-title":"An introduction to the epidemiology and burden of urinary tract infections.","volume":"11","author":"M Medina","year":"2019","journal-title":"Ther Adv Urol"},{"issue":"11","key":"pone.0277713.ref003","doi-asserted-by":"crossref","first-page":"2669","DOI":"10.1007\/s00345-019-03071-4","article-title":"Epidemiology of urological infections: a global burden","volume":"38","author":"R \u00d6zt\u00fcrk","year":"2020","journal-title":"World J Urol"},{"issue":"1","key":"pone.0277713.ref004","doi-asserted-by":"crossref","first-page":"ofw281","DOI":"10.1093\/ofid\/ofw281","article-title":"The increase in hospitalizations for urinary tract infections and the associated costs in the United States, 1998\u20132011.","volume":"4","author":"JE Simmering","year":"2017","journal-title":"Open Forum Infect Dis."},{"issue":"8","key":"pone.0277713.ref005","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/S1047-2797(00)00072-7","article-title":"Urinary tract infection: self-reported incidence and associated costs.","volume":"10","author":"B Foxman","year":"2000","journal-title":"Ann Epidemiol"},{"issue":"12","key":"pone.0277713.ref006","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1038\/nrurol.2010.190","article-title":"The epidemiology of urinary tract infection","volume":"7","author":"B. Foxman","year":"2010","journal-title":"Nat Rev Urol"},{"issue":"4","key":"pone.0277713.ref007","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1097\/01.ju.0000155596.98780.82","article-title":"Urologic diseases in America project: trends in resource use for urinary tract infections in women","volume":"173","author":"TL Griebling","year":"2005","journal-title":"J Urol"},{"key":"pone.0277713.ref008","volume-title":"Complicated urinary tract infections","author":"A Sabih","year":"2022"},{"issue":"5","key":"pone.0277713.ref009","doi-asserted-by":"crossref","first-page":"e103","DOI":"10.1093\/cid\/ciq257","article-title":"International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases","volume":"52","author":"K Gupta","year":"2011","journal-title":"Clin Infect Dis"},{"issue":"9","key":"pone.0277713.ref010","doi-asserted-by":"crossref","first-page":"ofy198","DOI":"10.1093\/ofid\/ofy198","article-title":"An assessment of inappropriate antibiotic use and guideline adherence for uncomplicated urinary tract infections.","volume":"5","author":"MJ Durkin","year":"2018","journal-title":"Open Forum Infect Dis."},{"issue":"5","key":"pone.0277713.ref011","doi-asserted-by":"crossref","first-page":"300","DOI":"10.14423\/SMJ.0000000000000278","article-title":"Assessment of appropriate antibiotic prescribing for urinary tract infections in an internal medicine clinic","volume":"108","author":"M Sigler","year":"2015","journal-title":"South Med J"},{"issue":"1","key":"pone.0277713.ref012","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1093\/biostatistics\/kxh020","article-title":"Estimating marginal and incremental effects on health outcomes using flexible link and variance function models.","volume":"6","author":"A Basu","year":"2005","journal-title":"Biostatistics."},{"issue":"4","key":"pone.0277713.ref013","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1007\/s00404-019-05256-z","article-title":"Prevention and treatment of uncomplicated lower urinary tract infections in the era of increasing antimicrobial resistance-non-antibiotic approaches: a systemic review","volume":"300","author":"S Wawrysiuk","year":"2019","journal-title":"Arch Gynecol Obstet"},{"issue":"4","key":"pone.0277713.ref014","doi-asserted-by":"crossref","first-page":"403","DOI":"10.33073\/pjm-2019-048","article-title":"Antibiotic resistance among uropathogenic Escherichia coli","volume":"68","author":"B. Kot","year":"2019","journal-title":"Pol J Microbiol"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0277713","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T18:37:27Z","timestamp":1669055847000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0277713"}},"subtitle":[],"editor":[{"given":"Vijayaprakash","family":"Suppiah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,11,21]]},"references-count":14,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,11,21]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0277713","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,21]]}}}