No abstract

SGLT2 inhibitors were associated with a small increased risk for UTI, UTI in diabetic women may lead to bladder and kidney dysfunction, and antibiotic treatment of ASB and UTI during pregnancy was associated with long-term effects on the neonate. Up-to-date research on the effectiveness and long-term effects of ASB screening and treatment policies, including group B Streptococcus bacteriuria in pregnancy, is warranted to inform clinical practice.

OBJECTIVE -Women with diabetes have a high incidence and complication rate of urinary tract infections (UTIs). Our aims were to compare current treatment strategies with respect to recurrence rates in women with diabetes with those without diabetes.RESEARCH DESIGN AND METHODS -We used a Dutch registration database containing pharmacy dispensing data. A total of 10,366 women with diabetes (17.5% premenopausal) (aged Յ55 years) and 200,258 women without diabetes (68% premenopausal) who received a first course of trimethoprim, nitrofurantoin, fosfomycin, or norfloxacin between January 1999 and January 2006 were included. We compared short (Յ5 days) with long (Ͼ5 days) prescriptions and norfloxacin with trimethoprim, nitrofurantoin, and fosfomycin. A recurrence was defined as a second prescription for one of the above-mentioned agents or a first with amoxicillin (clavulanic acid), fluoroquinolones, or trimethoprim/sulfamethoxazole between 6 and 30 days after inclusion.RESULTS -Premenopausal women with diabetes more often received a long (26.5 vs. 19.2%; P Ͻ 0.001) treatment with norfloxacin (10.7 vs. 6.2%; P Ͻ 0.001) but still had a higher recurrence rate (16.1 vs. 12.2%; P ϭ 0.003) compared with those without diabetes. Similarly, postmenopausal women with diabetes more often received a longer (32.8 vs. 28.8%; P Ͻ 0.001) treatment with norfloxacin (15.2 vs. 12.7%; P Ͻ 0.001) but had a higher recurrence rate (19.1 vs. 16.4%; P Ͻ 0.001) compared with those without diabetes.CONCLUSIONS -Despite the fact that patients with diabetes more often received longer and more potent initial treatment than patients without diabetes, pre-and postmenopausal women with diabetes more often had recurrences of their UTIs.