Catheterization Does Not Improve Course of Disease in Female Patients with Acute Cystitis or Pyelonephritis: Retrospective Analysis of >300 In-Hospital Treated Patients

Abstract

<b><i>Purpose:</i></b> Females with in-hospital treatment for acute cystitis (AC) or pyelonephritis may benefit from catheterization at admission. <b><i>Methods:</i></b> All female patients with AC or pyelonephritis requiring in-hospital treatment at University Hospital Frankfurt (2004–2019) were retrospectively analyzed. Logistic regression models were used to predict the catheter value. <b><i>Results:</i></b> Of 310 female patients, 40% harbored AC versus 60% pyelonephritis, of whom 62% and 74% received a catheter at admission: C-reactive protein (CRP) and white blood count (WBC) were significantly elevated in AC and pyelonephritis catheter versus no catheter patients (both <i>p</i> < 0.05). Time to CRP and WBC nadir did not differ between the AC catheter versus no catheter group (both <i>p</i> > 0.05). Conversely, time to CRP nadir was prolonged in pyelonephritis catheter patients. AC and pyelonephritis catheter patients exhibited a prolonged antibiotic treatment and length of stay (LOS, both <i>p</i> < 0.05). In multivariable analyses, CRP >5 ng/mL was a predictor for receiving a catheter in all patients. In AC, a positive urine culture and fever predicted, respectively, prolonged LOS or antibiotic treatment (all <i>p</i> < 0.05). <b><i>Conclusion:</i></b> Risk factors exist with regard to receiving a catheter and prolonged antibiotic treatment or LOS in females with AC or pyelonephritis. A catheter may not accelerate recovery or WBC nadir.

Identificación de agentes patógenos causantes de infecciones en vías urinarias en mujeres embarazadas con patrones de resistencia antimicrobiana.

“…Cuando se detecta una resistencia superior al 20%, es recomendable no emplear un solo antibiótico como tratamiento empírico. Para cistitis no complicadas se recomienda fosfomicina que mantiene la ecología de la zona 52,53 .…”