{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T22:04:49Z","timestamp":1790114689591,"version":"4.0.1"},"reference-count":31,"publisher":"Royal College of General Practitioners","issue":"734","license":[{"start":{"date-parts":[[2019,2,12]],"date-time":"2019-02-12T00:00:00Z","timestamp":1549929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Gen Pract"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Urinary tract infections (UTIs) are a common indication for antibiotic prescriptions, reductions in which would reduce antimicrobial resistance (AMR). Risk stratification of patients allows reductions to be made safely.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To identify risk factors for hospital admission following UTI, to inform targeted antibiotic stewardship.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and setting<\/jats:title><jats:p>Retrospective cohort study of East London primary care patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Hospital admission outcomes following primary care consultation for UTI were analysed using linked data from primary care, secondary care, and microbiology, from 1 April 2012 to 31 March 2017. The outcomes analysed were urinary infection-related hospital admission (UHA) and all-cause hospital admission (AHA) within 30 days of UTI in primary care. Odds ratios between specific variables (demographic characteristics, prior antibiotic exposure, and comorbidities) and the outcomes were predicted using generalised estimating equations, and fitted to a final multivariable model including all variables with a<jats:italic>P<\/jats:italic>-value &lt;0.1 on univariable analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 169 524 episodes of UTI, UHA occurred in 1336 cases (0.8%, 95% confidence interval [CI] = 0.7 to 0.8) and AHA in 6516 cases (3.8%, 95% CI = 3.8 to 3.9). On multivariable analysis, increased odds of UHA were seen in patients aged 55\u201374 years (adjusted odds ratio [AOR] 1.49) and \u226575 years (AOR 3.24), relative to adults aged 16\u201334 years. Increased odds of UHA were also associated with chronic kidney disease (CKD; AOR 1.55), urinary catheters (AOR 2.01), prior antibiotics (AOR 1.38 for \u22653 courses), recurrent UTI (AOR 1.33), faecal incontinence (FI; AOR 1.47), and diabetes mellitus (DM; AOR 1.37).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Urinary infection-related hospital admission after primary care consultation for community-onset lower UTI was rare; however, increased odds for UHA were observed for some patient groups. Efforts to reduce antibiotic prescribing for suspected UTI should focus on patients aged &lt;55 years without risk factors for complicated UTI, recurrent UTI, DM, or FI.<\/jats:p><\/jats:sec>","DOI":"10.3399\/bjgp.2022.0592","type":"journal-article","created":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T13:10:14Z","timestamp":1683033014000},"page":"e694-e701","source":"Crossref","is-referenced-by-count":8,"title":["Hospital admission after primary care consultation for community-onset lower urinary tract infection: a cohort study of risks and predictors using linked data"],"prefix":"10.3399","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9537-8011","authenticated-orcid":false,"given":"Anna","family":"Aryee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6499-7933","authenticated-orcid":false,"given":"Patrick","family":"Rockenschaub","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6889-0415","authenticated-orcid":false,"given":"John","family":"Robson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0732-8167","authenticated-orcid":false,"given":"Marian","family":"Priebe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaheer","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caoimhe Nic","family":"Fhogartaigh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Ball","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3549-6232","authenticated-orcid":false,"given":"Andrew","family":"Hayward","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1713-2555","authenticated-orcid":false,"given":"Laura","family":"Shallcross","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1987","published-online":{"date-parts":[[2023,5,2]]},"reference":[{"key":"2023090614550708000_73.734.e694.1","unstructured":"Hippisley-Cox J Vinogradova Y (2009) Trends in consultation rates in general practice 1995\/1996 to 2008\/2009: analysis of the QResearch\u00ae database (QResearch\u00ae and NHS Information Centre for Health and Social Care, London)."},{"key":"2023090614550708000_73.734.e694.2","doi-asserted-by":"crossref","unstructured":"Booth JL Mullen AB Thomson DAM (2013) Antibiotic treatment of urinary tract infection by community pharmacists: a cross-sectional study. 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