PMID- 28544925
OWN - NLM
STAT- MEDLINE
DCOM- 20180105
LR  - 20220409
IS  - 1872-8227 (Electronic)
IS  - 0168-8227 (Linking)
VI  - 129
DP  - 2017 Jul
TI  - Less workup, longer treatment, but no clinical benefit observed in women with 
      diabetes and acute cystitis.
PG  - 197-202
LID - S0168-8227(16)31737-5 [pii]
LID - 10.1016/j.diabres.2017.05.005 [doi]
AB  - AIMS: There is a lack of evidence on the optimal approach for treating acute 
      cystitis in women with diabetes. We performed an outpatient database study to 
      compare management of women with and without diabetes and to assess the effect of 
      treatment duration on early and late recurrence. METHODS: We used the EPIC 
      Clarity database (electronic medical record system) to identify all female 
      patients aged >/=18years with acute cystitis in two family medicine clinics and a 
      urology department. An index case was defined as the first cystitis episode 
      during the study period (2011-2014) with follow-up data of at least 12months. 
      Recurrence was defined as a Urinary Tract Infection (UTI) episode, plus a new 
      prescription for an antibiotic, between 6 and 29days (early), or between 30days 
      and 12months (late). RESULTS: We included 2327 visits for cystitis representing 
      1845 unique patients. Women with diabetes and acute cystitis were less likely to 
      receive urinary tests to work up cystitis, and received significantly longer 
      treatment courses of antibiotics. There was a higher risk of early recurrence in 
      women with treatment duration >5days (odds ratio 2.17, 95% confidence interval 
      1.07-4.41) in multivariate analyses. Longer treatment was not associated with 
      late UTI recurrence. Presence of diabetes, and Charlson comorbidity score were 
      independent determinants of late recurrence. CONCLUSIONS: Longer treatment of 
      cystitis was not associated with lower recurrence rates. This calls into question 
      whether many episodes of diabetic cystitis may be managed with a short course of 
      antibiotics, as for uncomplicated disease.
CI  - Copyright (c) 2017 Elsevier B.V. All rights reserved.
FAU - Grigoryan, Larissa
AU  - Grigoryan L
AD  - Department of Family and Community Medicine, Baylor College of Medicine, Houston, 
      TX, USA. Electronic address: grigorya@bcm.edu.
FAU - Zoorob, Roger
AU  - Zoorob R
AD  - Department of Family and Community Medicine, Baylor College of Medicine, Houston, 
      TX, USA.
FAU - Wang, Haijun
AU  - Wang H
AD  - Department of Family and Community Medicine, Baylor College of Medicine, Houston, 
      TX, USA.
FAU - Horsfield, Matthew
AU  - Horsfield M
AD  - Department of Family and Community Medicine, Baylor College of Medicine, Houston, 
      TX, USA.
FAU - Gupta, Kalpana
AU  - Gupta K
AD  - Section of Infectious Diseases, Department of Medicine, Boston Veterans Affairs 
      Healthcare System and Boston University School of Medicine, Boston, MA, USA.
FAU - Trautner, Barbara W
AU  - Trautner BW
AD  - Houston VA Center for Innovations in Quality, Effectiveness and Safety (IQuESt), 
      Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA; Section of 
      Infectious Diseases, Departments of Medicine and Surgery, Baylor College of 
      Medicine, Houston, TX, USA.
LA  - eng
PT  - Journal Article
DEP - 20170512
PL  - Ireland
TA  - Diabetes Res Clin Pract
JT  - Diabetes research and clinical practice
JID - 8508335
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Acute Disease
MH  - Adult
MH  - Aged
MH  - Anti-Bacterial Agents/*therapeutic use
MH  - Cohort Studies
MH  - Comorbidity
MH  - Cystitis/*therapy
MH  - Diabetes Mellitus/*drug therapy
MH  - Female
MH  - Humans
MH  - Middle Aged
MH  - Recurrence
MH  - Retrospective Studies
MH  - Urinary Tract Infections/*etiology
OTO - NOTNLM
OT  - Antibacterial agents
OT  - Diabetes mellitus
OT  - Urinary tract infections
EDAT- 2017/05/26 06:00
MHDA- 2018/01/06 06:00
CRDT- 2017/05/26 06:00
PHST- 2016/12/07 00:00 [received]
PHST- 2017/05/08 00:00 [accepted]
PHST- 2017/05/26 06:00 [pubmed]
PHST- 2018/01/06 06:00 [medline]
PHST- 2017/05/26 06:00 [entrez]
AID - S0168-8227(16)31737-5 [pii]
AID - 10.1016/j.diabres.2017.05.005 [doi]
PST - ppublish
SO  - Diabetes Res Clin Pract. 2017 Jul;129:197-202. doi: 
      10.1016/j.diabres.2017.05.005. Epub 2017 May 12.