A significant percentage of patients with uncomplicated urinary tract infection (UTI) are treated with an empiric antibiotic agent to which the etiologic bacteria is resistant, according to results of a study presented at American Society of Microbiology (ASM) Microbe 2019 held from June 20-24, 2019, in San Francisco, California.

Rates of antibiotic resistance associated with UTI have increased in recent years. To evaluate the rate of treatment failure as a result of antibiotic resistance, researchers conducted a large retrospective analysis of data from 387,028 patients in the Aetna claims database. They identified 500,318 cases of UTI, demonstrating an average of 1.3 episodes per patient; however, demographic, pathogen susceptibility, and treatment outcome information were available for 43,659 episodes (8.7%). The average age of the study cohort was 54.5 years, 89% were female, and 17.2% had diabetes mellitus.

Results demonstrated that overall treatment success occurred in 65.5% of cases. Treatment success was more likely in patients who did not have a resistant UTI compared with those who did (69.7% vs 42.0%, P <.001). Of the patients who had a UTI resistant to the first antibiotic, 40% of those with diabetes had a successful treatment outcome compared with 41.2% of patients without diabetes. Overall, patients with diabetes were more likely to experience treatment failure: 66.5% patients without diabetes showed treatment success compared with 60.6% of those with diabetes.

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Researchers concluded that approximately 15% of patients who had an uncomplicated UTI received empiric treatment to which the offending organism was resistant, leading to significant rates of treatment failure.


Dunn M, Snow K, Mehta R. Failure of empiric treatment of uncomplicated urinary tract infection (UTI) associated with resistant pathogens. Presented at: ASM Microbe 2019; June 20-24, 2019; San Francisco, CA. Poster P403.