A Cost–Effectiveness Analysis of Treatment Strategies for Acute Uncomplicated Pyelonephritis in Women

Yen, Zui-Shen; Davis, Mark A.; Chen, Shyr‐Chyr; Chen, Wen‐Jone

doi:10.1111/j.1553-2712.2003.tb01341.x

Cited by 9 publications

(7 citation statements)

References 24 publications

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“…Ineffective empiric antibiotic therapy may contribute to increased morbidity and increased costs due to prolonged antibiotic treatment, recurrent office or emergency room visits, and hospital admissions [Yen et al 2003]. In 2010, the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases updated the practice guidelines for uncomplicated UTIs [Gupta et al 2011].…”

Section: Antibiotic Misusementioning

confidence: 99%

Antibiotic resistance in pediatric urology

Edlin

Copp

2013

Therapeutic Advances in Urology

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Antibiotics are a mainstay in the treatment of bacterial infections, though their use is a primary risk factor for the development of antibiotic resistance. Antibiotic resistance is a growing problem in pediatric urology as demonstrated by increased uropathogen resistance. Lack of urine testing, nonselective use of prophylaxis, and poor empiric prescribing practices exacerbate this problem. This article reviews antibiotic utilization in pediatric urology with emphasis on modifiable practice patterns to potentially help mitigate the growing rates of antibiotic resistance. This includes urine testing to only treat when indicated and tailor broadspectrum therapy as able; selective application of antibiotic prophylaxis to patients with highgrade vesicoureteral reflux and hydronephrosis with counseling regarding the importance of compliance; and using local antiobiograms, particularly pediatric-specific antiobiograms, with inpatient versus outpatient data.

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Section: Antibiotic Misusementioning

confidence: 99%

Antibiotic resistance in pediatric urology

Edlin

Copp

2013

Therapeutic Advances in Urology

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“…[ 9 ] Unable to fi nd relevant utility data for patients with acute pylonephritis, Yen et al . [ 25 ] asked a panel of six emergency physicians and internists to develop utility weights using the standard reference gamble technique. Pylonephritis was assigned a QALY of 0.90, 0.87 for pylonephritis with mild side effects, and 0.81 for pylonephritis with serious side effects.…”

Section: Quality Of Life In Patients With a Utimentioning

confidence: 99%

Systematic review of the impact of urinary tract infections on health‐related quality of life

Bermingham

Ashe

2012

BJU International

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What ' s known on the subject? and What does the study add? Values for equivalent health states can vary substantially depending on the measure used and method of valuation; this has a direct impact on the results of economic analyses. To date, the majority of existing economic evaluations that include UTI as a health state refer to an analysis in which the Index of Well Being was used to estimate the quality of life experienced by young women with UTIs. Currently, there are no validated methods or fi lters for systematically searching for the type of generic quality of life data required for decision analytic models.This study is the only systematic review of quality of life in people with UTI in the literature. Twelve studies were identifi ed which report quality of life using a variety of generic methods; the results of these papers were summarized in a way that is useful for a health researcher seeking to populate a decision model, design a clinical study or assess the effect of UTI on quality of life relative to other conditions. One research group provided previously unpublished data from a large cohort study; these scores were mapped to EuroQol 5-Dimension values using published algorithms and probabilistic simulations.The aim of this review was to identify studies that have evaluated the impact of symptomatic urinary tract infection (UTI) and UTI-associated bacteraemia on quality of life, and to summarize these data in a way that is useful for a health researcher seeking to populate a cost -utility model, design a clinical study or assess the effect of UTIs on quality of life relative to other conditions. We conducted a systematic search of the literature using MEDLINE, EMBASE, the NHS Economic Evaluations database, Health Technology Assessment database, Health Economics Evaluations database, Cost-Effectiveness Analysis Registry and EuroQol website. Studies that reported utility values for symptomatic UTI or UTI-associated bacteraemia derived from a generic QoL measurement tool or expert opinion were included. Studies using disease-specifi c instruments were excluded. Twelve studies were identifi ed that included a generic measure of health-related quality of life for patients with UTIs. These measures included: the short-form (SF)-36 and SF-12 questionnaires; the Health Utilities Index Mark 2; Quality of Well Being; the Index of Well Being, standard gamble; the Health and Activity Limitation Index; and expert opinion. The authors of studies using either of the SF questionnaires were contacted for additional data. One research group provided previously unpublished data from a large cohort study; these scores were mapped to EuroQol 5-Dimension (EQ-5D) values using published algorithms and probabilistic simulations. The present review provides health researchers with several sources from which to select utility values to populate cost -utility models. It also shows that very few studies have measured quality of life in patients with UTI using generic preference-based measures of health and none have evalua...

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“…Ineffective empirical antibiotic therapy may contribute not only to increased morbidity, but also to increased costs due to prolonged antibiotic treatment, recurrent office or emergency room visits and hospital admissions. 3 …”

mentioning

confidence: 99%

Antibiotic Resistance Patterns of Outpatient Pediatric Urinary Tract Infections

et al. 2013

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Purpose We characterize the current national patterns of antibiotic resistance of outpatient pediatric urinary tract infection. Materials and Methods We examined outpatient urinary isolates from patients younger than 18 years in 2009 using The Surveillance Network®, a database with antibiotic susceptibility results and patient demographic data from 195 United States hospitals. We determined the prevalence and antibiotic resistance patterns for the 6 most common uropathogens, ie Escherichia coli, Proteus mirabilis, Klebsiella, Enterobacter, Pseudomonas aeruginosa and Enterococcus. We compared differences in uropathogen prevalence between males and females using chi-square analysis. Results We identified 25,418 outpatient urinary isolates. E. coli was the most common uropathogen overall but the prevalence of E. coli was higher among females (83%) than males (50%, p <0.001). Other common species among males were Enterococcus (17%), P. mirabilis (11%) and Klebsiella (10%). However, these uropathogens each accounted for 5% or less of female isolates (p <0.001). Resistance among E. coli was highest for trimethoprim-sulfamethoxazole (24%) but lower for nitrofurantoin (less than 1%) and cephalothin (15%). Compared to 2002 Surveillance Network data, E. coli resistance rates increased for trimethoprim-sulfamethoxazole (from 23% to 31% in males and from 20% to 23% in females) and ciprofloxacin (from 1% to 10% and from 0.6% to 4%, respectively). Conclusions E. coli remains the most common pediatric uropathogen. Although widely used, trimethoprim-sulfamethoxazole is a poor empirical choice for pediatric urinary tract infections in many areas due to high resistance rates. First-generation cephalosporins and nitrofurantoin are appropriate narrow-spectrum alternatives given their low resistance rates. Local antibiograms should be used to assist with empirical urinary tract infection treatment.

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A Cost–Effectiveness Analysis of Treatment Strategies for Acute Uncomplicated Pyelonephritis in Women

Cited by 9 publications

References 24 publications

Antibiotic resistance in pediatric urology

Antibiotic resistance in pediatric urology

Systematic review of the impact of urinary tract infections on health‐related quality of life

Antibiotic Resistance Patterns of Outpatient Pediatric Urinary Tract Infections

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