Accepted for/Published in: JMIR Research Protocols
Date Submitted: Nov 23, 2022
Date Accepted: Dec 20, 2022
Management of Urinary Tract Infections in Catalonia: adequacy of diagnostic and therapeutic management, predictors of complications and impact of suppressive therapies on the severity of potentially serious infections - Project ITUCAT: a protocol of observational study
ABSTRACT
Background:
Antibiotic resistance is an individual health and public health problem worldwide. Unnecessary use of antimicrobials is the most important cause of resistance generation in the community, and it is estimated that 80 % of antimicrobials are prescribed in primary health care. One of the most frequent causes of prescription of antimicrobials are urinary tract infections (UTI).
Objective:
This paper presents the first phase of ITUCAT project protocol. We aim to know the epidemiology of the different types of UTI in Catalonia (Spain) and their diagnostic and therapeutic management by health professionals. Furthermore, we aim to evaluate the correlation between the total consumption and type of antibiotics for recurrent UTI with the presence and severity of infectious complications of urological origin, especially pyelonephritis and sepsis, and two potentially serious infections: pneumonia and COVID-19.
Methods:
The study is a population-based observational study. The population includes adults with a diagnosis of UTI registered in the Information System for Research in Primary Care (SIDIAP) of Catalonia during 2012 – 2021.
Results:
We expect to describe the epidemiology of UTI in Catalonia during 2012-2021, as well as to describe the diagnostic and therapeutic management of UTI by medical staff.
Conclusions:
We expect to find a high percentage of inadequate management of UTIs, considering that on many occasions they are treated with second- or third-line antibiotic therapies, with a preference for the longest regimens. Another objective to be analyzed is that the use of antibiotic suppressive therapies, or prophylaxis, in recurrent UTIs could be highly variable in our study. In addition, we want to check whether women with recurrent UTIs treated with antibiotic suppressive therapies have a higher incidence and severity of potentially serious future infections, with special relevance to acute pyelonephritis, urosepsis, COVID-19 and pneumonia, versus women who are treated with antibiotics when they present an UTI. Clinical Trial: This study is registered in the EU PAS register (EUPAS49724).
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