TY - JOUR
T1 - Nitrofurantoin failure in elderly men
T2 - A retrospective observational study
AU - Wolterink, Ilse
AU - Verheij, Theo
AU - Platteel, Tamara
AU - Bruel Van Den, Ann
AU - Stam, Arjen
AU - Pol Van De, Alma
N1 - Funding Information:
Acknowledgements. This research is partially supported by the Singapore National Research Foundation under its International Research Centre @ Singapore Funding Initiative and administered by the IDM Programme Office, Media Development Authority (MDA).
Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2020/4/27
Y1 - 2020/4/27
N2 - Urinary tract infections in the elderly are common. Treatment with nitrofurantoin in men may not be sufficient if concomitant tissue involvement is present, resulting in treatment failure. The aim of this study is to determine the prevalence of nitrofurantoin failure in the elderly, and to assess the effect of gender and age. A retrospective observational study was conducted using a Dutch general practice medical record database of 21,789 men and 26,622 women aged 65 years or older in 2015. First, nitrofurantoin prescriptions in 2015 were analyzed. Nitrofurantoin failure (subsequent prescription of antibiotic within 30 days) for men, women, and different age categories were compared. The effect of age and gender was assessed using multivariate logistic regression. A total of 3537 patients had a first nitrofurantoin prescription in 2015; 506 men and 3031 women. Overall, 584 patients (17%) experienced nitrofurantoin failure; 135 (27%) men and 449 (15%) women. Male gender (odds ratio (OR) = 2.09, 95% confidence interval (CI) 1.68–2.61) and age (OR = 1.02, 95% CI 1.01–1.03) was associated with higher treatment failure. Our findings indicate that in a substantial number of elderly men, nitrofurantoin might not be the appropriate treatment. Nitrofurantoin, as a first choice in elderly men with urinary tract infections, should be reconsidered.
AB - Urinary tract infections in the elderly are common. Treatment with nitrofurantoin in men may not be sufficient if concomitant tissue involvement is present, resulting in treatment failure. The aim of this study is to determine the prevalence of nitrofurantoin failure in the elderly, and to assess the effect of gender and age. A retrospective observational study was conducted using a Dutch general practice medical record database of 21,789 men and 26,622 women aged 65 years or older in 2015. First, nitrofurantoin prescriptions in 2015 were analyzed. Nitrofurantoin failure (subsequent prescription of antibiotic within 30 days) for men, women, and different age categories were compared. The effect of age and gender was assessed using multivariate logistic regression. A total of 3537 patients had a first nitrofurantoin prescription in 2015; 506 men and 3031 women. Overall, 584 patients (17%) experienced nitrofurantoin failure; 135 (27%) men and 449 (15%) women. Male gender (odds ratio (OR) = 2.09, 95% confidence interval (CI) 1.68–2.61) and age (OR = 1.02, 95% CI 1.01–1.03) was associated with higher treatment failure. Our findings indicate that in a substantial number of elderly men, nitrofurantoin might not be the appropriate treatment. Nitrofurantoin, as a first choice in elderly men with urinary tract infections, should be reconsidered.
KW - Anti-bacterial agents
KW - Elderly
KW - Nitrofurantoin
KW - Primary care
KW - Treatment failure
KW - Urinary tract infections
UR - http://www.scopus.com/inward/record.url?scp=85084238143&partnerID=8YFLogxK
U2 - 10.3390/antibiotics9050211
DO - 10.3390/antibiotics9050211
M3 - Article
C2 - 32349325
AN - SCOPUS:85084238143
SN - 2079-6382
VL - 9
JO - Antibiotics
JF - Antibiotics
IS - 5
M1 - 211
ER -