TY - JOUR
T1 - Five versus seven days of nitrofurantoin for urinary tract infections in women with diabetes
T2 - a retrospective cohort study
AU - Hendriks-Spoor, Kelly D.
AU - Wille, Floor L.
AU - Doesschate, Thijs ten
AU - Dorigo-Zetsma, Julia W.
AU - Verheij, Theo J.M.
AU - van Werkhoven, Cornelis H.
N1 - Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.
PY - 2022/3
Y1 - 2022/3
N2 - Objective: To compare the effectiveness of 5 versus 7 days of nitrofurantoin treatment for urinary tract infection (UTI) in women with diabetes. Methods: Data were collected retrospectively from Dutch general practitioners between 2013 and 2020. Nitrofurantoin prescriptions with a duration of 5 days (5DN) or 7 days (7DN) in women with diabetes were included. Inverse propensity weighting was performed to calculate adjusted risk differences (RD) for treatment failure within 28 days. Secondary outcomes were 14-day treatment failure, severe treatment failure and 28-day treatment failure in defined risk groups. Results: Nitrofurantoin was prescribed in 6866 episodes, 3247 (47.3%) episodes with 5DN and 3619 (52.7%) episodes with 7DN. Patients in the 7DN group had more co-morbidities, more diabetes-related complications and were more insulin-dependent. There were 517/3247 (15.9%) failures in the 5DN group versus 520/3619 (14.4%) in the 7DN group. The adjusted RD for failure within 28 days was 1.4% (95% CI –0.6 to 3.4). Conclusion: We found no clinically significant difference in treatment failure in women with diabetes with UTI treated with either 5DN or 7DN within 28 days. A 5-day treatment should be considered to reduce cumulative nitrofurantoin exposure in DM patients.
AB - Objective: To compare the effectiveness of 5 versus 7 days of nitrofurantoin treatment for urinary tract infection (UTI) in women with diabetes. Methods: Data were collected retrospectively from Dutch general practitioners between 2013 and 2020. Nitrofurantoin prescriptions with a duration of 5 days (5DN) or 7 days (7DN) in women with diabetes were included. Inverse propensity weighting was performed to calculate adjusted risk differences (RD) for treatment failure within 28 days. Secondary outcomes were 14-day treatment failure, severe treatment failure and 28-day treatment failure in defined risk groups. Results: Nitrofurantoin was prescribed in 6866 episodes, 3247 (47.3%) episodes with 5DN and 3619 (52.7%) episodes with 7DN. Patients in the 7DN group had more co-morbidities, more diabetes-related complications and were more insulin-dependent. There were 517/3247 (15.9%) failures in the 5DN group versus 520/3619 (14.4%) in the 7DN group. The adjusted RD for failure within 28 days was 1.4% (95% CI –0.6 to 3.4). Conclusion: We found no clinically significant difference in treatment failure in women with diabetes with UTI treated with either 5DN or 7DN within 28 days. A 5-day treatment should be considered to reduce cumulative nitrofurantoin exposure in DM patients.
KW - Cystitis
KW - Diabetes mellitus
KW - duration
KW - Nitrofurantoin
KW - Primary care
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=85111586148&partnerID=8YFLogxK
U2 - 10.1016/j.cmi.2021.06.034
DO - 10.1016/j.cmi.2021.06.034
M3 - Article
C2 - 34245906
AN - SCOPUS:85111586148
SN - 1198-743X
VL - 28
SP - 377
EP - 382
JO - Clinical Microbiology and Infection
JF - Clinical Microbiology and Infection
IS - 3
ER -