Ioana D Olaru1,2, Mutsawashe Chisenga2, Shunmay Yeung1,3, Prosper Chonzi4, Kudzai P E Masunda4, Rashida A Ferrand1,2, Katharina Kranzer1,2,5. 1. London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK. 2. Biomedical Research and Training Institute, 10 Seagrave Road, Avondale, Harare, Zimbabwe. 3. Department of Paediatric Infectious Disease, St Mary's Imperial College Hospital, Praed St, Paddington, London, W2 1NY, UK. 4. Department of Health, Harare City Council, Rowan Martin Building, 1 Pennefather Avenue, Harare, Zimbabwe. 5. Division of Infectious and Tropical Medicine, Medical Centre of the University of Munich, Leopoldstrasse, Munich, 80802, Germany.
Abstract
Background: Treatment for urinary tract infections (UTIs) is usually empiric and is based on local antimicrobial resistance data. These data, however, are scarce in low-resource settings. The aim of this study is to determine the impact of antibiotic treatment on clinical and bacteriological outcomes in patients presenting with UTI symptoms to primary care in Harare. Methods: This cohort study enrolled participants presenting with UTI symptoms to 10 primary healthcare clinics in Harare between July 2019 and July 2020. A questionnaire was administered and a urine sample was collected for culture. If the urine culture showed growth of ≥10 5 colony forming units/mL of a uropathogen, a follow up visit at 7-21 days was conducted. Results: The analysis included 168 participants with a median age of 33.6 years (IQR 25.1-51.4) and of whom 131/168 (78.0%) were female. Effective treatment was taken by 54/168 (32.1%) participants. The urine culture was negative at follow up in 41/54 (75.9%) of participants who took appropriate treatment and in 33/114 (28.9%, p<0.001) of those who did not. Symptoms had improved or resolved in 52/54 (96.3%) of those on appropriate treatment and in 71/114 (62.3%, p<0.001) of those without. Conclusion: The findings of this study show that effective treatment leads to symptom resolution and bacterial clearance in people presenting with UTIs to primary care. Although UTIs are not life-threatening and can resolve without treatment, they do impact on quality of life, highlighting the need for optimised treatment recommendations. Copyright:
Background: Treatment for urinary tract infections (UTIs) is usually empiric and is based on local antimicrobial resistance data. These data, however, are scarce in low-resource settings. The aim of this study is to determine the impact of antibiotic treatment on clinical and bacteriological outcomes in patients presenting with UTI symptoms to primary care in Harare. Methods: This cohort study enrolled participants presenting with UTI symptoms to 10 primary healthcare clinics in Harare between July 2019 and July 2020. A questionnaire was administered and a urine sample was collected for culture. If the urine culture showed growth of ≥10 5 colony forming units/mL of a uropathogen, a follow up visit at 7-21 days was conducted. Results: The analysis included 168 participants with a median age of 33.6 years (IQR 25.1-51.4) and of whom 131/168 (78.0%) were female. Effective treatment was taken by 54/168 (32.1%) participants. The urine culture was negative at follow up in 41/54 (75.9%) of participants who took appropriate treatment and in 33/114 (28.9%, p<0.001) of those who did not. Symptoms had improved or resolved in 52/54 (96.3%) of those on appropriate treatment and in 71/114 (62.3%, p<0.001) of those without. Conclusion: The findings of this study show that effective treatment leads to symptom resolution and bacterial clearance in people presenting with UTIs to primary care. Although UTIs are not life-threatening and can resolve without treatment, they do impact on quality of life, highlighting the need for optimised treatment recommendations. Copyright:
Authors: T C M Christiaens; M De Meyere; G Verschraegen; W Peersman; S Heytens; J M De Maeseneer Journal: Br J Gen Pract Date: 2002-09 Impact factor: 5.386
Authors: Patrick Musicha; Jennifer E Cornick; Naor Bar-Zeev; Neil French; Clemens Masesa; Brigitte Denis; Neil Kennedy; Jane Mallewa; Melita A Gordon; Chisomo L Msefula; Robert S Heyderman; Dean B Everett; Nicholas A Feasey Journal: Lancet Infect Dis Date: 2017-08-14 Impact factor: 25.071