{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T16:39:34Z","timestamp":1790786374955,"version":"4.1.0"},"reference-count":30,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T00:00:00Z","timestamp":1669248000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Primary Healthcare Management in Region Sk\u00e5ne (EP21)","award":["EP21"],"award-info":[{"award-number":["EP21"]}]},{"name":"Primary Healthcare Management in Region Sk\u00e5ne (EP21)","award":["2022-0071"],"award-info":[{"award-number":["2022-0071"]}]},{"name":"Primary Healthcare Management in Region Sk\u00e5ne (EP21)","award":["SLS-960562"],"award-info":[{"award-number":["SLS-960562"]}]},{"name":"Primary Healthcare Management in Region Sk\u00e5ne (EP21)","award":["SLS-960574"],"award-info":[{"award-number":["SLS-960574"]}]},{"name":"Primary Healthcare Management in Region Sk\u00e5ne (EP21)","award":["SLS-971425"],"award-info":[{"award-number":["SLS-971425"]}]},{"name":"ALF","award":["EP21"],"award-info":[{"award-number":["EP21"]}]},{"name":"ALF","award":["2022-0071"],"award-info":[{"award-number":["2022-0071"]}]},{"name":"ALF","award":["SLS-960562"],"award-info":[{"award-number":["SLS-960562"]}]},{"name":"ALF","award":["SLS-960574"],"award-info":[{"award-number":["SLS-960574"]}]},{"name":"ALF","award":["SLS-971425"],"award-info":[{"award-number":["SLS-971425"]}]},{"name":"Swedish Society of Medicine","award":["EP21"],"award-info":[{"award-number":["EP21"]}]},{"name":"Swedish Society of Medicine","award":["2022-0071"],"award-info":[{"award-number":["2022-0071"]}]},{"name":"Swedish Society of Medicine","award":["SLS-960562"],"award-info":[{"award-number":["SLS-960562"]}]},{"name":"Swedish Society of Medicine","award":["SLS-960574"],"award-info":[{"award-number":["SLS-960574"]}]},{"name":"Swedish Society of Medicine","award":["SLS-971425"],"award-info":[{"award-number":["SLS-971425"]}]},{"name":"SSAC Foundation","award":["EP21"],"award-info":[{"award-number":["EP21"]}]},{"name":"SSAC Foundation","award":["2022-0071"],"award-info":[{"award-number":["2022-0071"]}]},{"name":"SSAC Foundation","award":["SLS-960562"],"award-info":[{"award-number":["SLS-960562"]}]},{"name":"SSAC Foundation","award":["SLS-960574"],"award-info":[{"award-number":["SLS-960574"]}]},{"name":"SSAC Foundation","award":["SLS-971425"],"award-info":[{"award-number":["SLS-971425"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: The risk of pyelonephritis following uncomplicated lower urinary tract infection (cystitis) in women has not been studied in well-powered samples. This is likely due to the previous lack of nationwide primary healthcare data. We aimed to examine the risks of pyelonephritis following cystitis in women and explore if antibiotic treatment, cervical cancer, parity, and sociodemographic factors are related to these risks. Methods: This was a nationwide cohort study (2006\u20132018) of 752,289 women diagnosed with uncomplicated cystitis in primary healthcare settings. Of these, 404 696 did not redeem an antibiotic prescription within five days from cystitis. Logistic regression models were used to calculate odds ratios for pyelonephritis within 30 days and 90 days following the cystitis event. Results: Around one percent (7454) of all women with cystitis were diagnosed with pyelonephritis within 30 days, of which 78.2% had not redeemed an antibiotic for their cystitis. Antibiotic treatment was inversely associated with both outpatient registration and hospitalization due to pyelonephritis, with odds ratios of 0.85 (95% CI 0.80 to 0.91) and 0.65 (95% CI 0.55 to 0.77), respectively. Sociodemographic factors, parity, and cervical cancer were, with few exceptions (e.g., age and region of residency), not associated with pyelonephritis. Conclusions: Antibiotic treatment was inversely associated with pyelonephritis, but the absolute risk reduction was low. Non-antibiotic treatment for cystitis might be a safe option for most women. Future studies identifying the women at the highest risks will help clinicians in their decision making when treating cystitis, while keeping the ecological costs of antibiotics in mind.<\/jats:p>","DOI":"10.3390\/antibiotics11121695","type":"journal-article","created":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T02:29:23Z","timestamp":1669343363000},"page":"1695","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["The Risk of Pyelonephritis Following Uncomplicated Cystitis: A Nationwide Primary Healthcare Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0670-9996","authenticated-orcid":false,"given":"Filip","family":"Jans\u00e5ker","sequence":"first","affiliation":[{"name":"Center for Primary Health Care Research, Department of Clinical Sciences Malm\u00f6, Lund University, 205 02 Malm\u00f6, Sweden"},{"name":"Department of Clinical Microbiology, Rigshospitalet, DK-2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5559-4657","authenticated-orcid":false,"given":"Xinjun","family":"Li","sequence":"additional","affiliation":[{"name":"Center for Primary Health Care Research, Department of Clinical Sciences Malm\u00f6, Lund University, 205 02 Malm\u00f6, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8947-2914","authenticated-orcid":false,"given":"Ingvild","family":"Vik","sequence":"additional","affiliation":[{"name":"The Antibiotic Centre for Primary Care, Department of General Practice, Institute of Health and Society, University of Oslo, 0318 Oslo, Norway"},{"name":"Oslo Accident and Emergency Outpatient Clinic, City of Oslo Health Agency, 0661 Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1966-8302","authenticated-orcid":false,"given":"Niels","family":"Frimodt-M\u00f8ller","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Rigshospitalet, DK-2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8699-9956","authenticated-orcid":false,"given":"Jenny Dahl","family":"Knudsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Rigshospitalet, DK-2100 Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Sundquist","sequence":"additional","affiliation":[{"name":"Center for Primary Health Care Research, Department of Clinical Sciences Malm\u00f6, Lund University, 205 02 Malm\u00f6, Sweden"},{"name":"Center for Community-Based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Shimane 693-8501, Japan"},{"name":"Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"100108","DOI":"10.1016\/j.lanepe.2021.100108","article-title":"Sociodemographic factors and uncomplicated cystitis in women aged 15\u201350 years: A nationwide Swedish cohort registry study (1997\u20132018)","volume":"4","author":"Li","year":"2021","journal-title":"Lancet Reg. 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J. Gen. Pract."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/11\/12\/1695\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:26:15Z","timestamp":1760145975000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/11\/12\/1695"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,24]]},"references-count":30,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["antibiotics11121695"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics11121695","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,24]]}}}