Antibiotic prescribing for urinary tract infections in women residing in long-term care: A retrospective cohort study
Bibliographic record
Abstract
Introduction: This study describes all antibiotics dispensed to long-term care (LTC)-dwelling women with a suspected or confirmed uncomplicated urinary tract infection (UTI) in health administrative data. The outcomes of ambulatory visits, hospitalizations, and dispensation of additional antibiotics were compared for those dispensed fluoroquinolones (FQs) and those dispensed other antibiotics. Methods: This retrospective cohort study assessed administrative health data collected between January 2005 and March 2020 in Nova Scotia, Canada. Women aged 65 years or older who resided in LTC, identified with ICD 9 or 10 codes that represented an uncomplicated UTI and had an antibiotic dispensation within 5 days of the identified UTI code, were included. Antibiotic dispensations were reported descriptively and a Mann-Kendall test was used to assess change over time. A logistic regression model estimated the odds ratios for FQ compared to non-FQ recipients for all outcome events. Results: < 0.001]). The most dispensed antibiotics were trimethoprim-sulfamethoxazole (25.8%), nitrofurantoin (25.5%), and ciprofloxacin (18.6 %). Compared to all other antibiotics, FQ dispensation was not associated with any difference in need for hospitalization. There was a reduced risk of subsequent antibiotic dispensation and follow-up ambulatory care visits for those dispensed FQs in the adjusted analysis. Conclusions: A decline in antibiotic dispensations associated with uncomplicated UTI events was observed over the 15-year period. The findings support guideline recommendations to limit FQ prescribing for uncomplicated UTI, as few differences for the outcomes investigated were identified.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".