English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Background  Despite well-established guidelines for urinary tract infection (UTI) treatment, prescribing practices vary. We examined the association between inappropriate (IA) or suboptimal (SO) antibiotic (AB) prescribing (RX) and hospitalization, healthcare resource use (HRU), and costs among patients with uncomplicated UTI (uUTI) in the US.    Methods  This retrospective cohort study used linked Premier Healthcare/Optum claims data from female outpatients (≥ 12 years old) with a uUTI diagnosis (January 1, 2013 to December 31, 2018). Patients with complicated UTIs (eg, urological abnormalities, medications/procedures associated with complicated UTI, or intravenous AB receipt at index) were excluded. HRU and costs between patients with IA/SO and appropriate and optimal (AP&OP) AB RX (defined in  Table 1 ) were assessed from Optum claims data during index episode (within 28 days of index) and 12-month follow-up.  Table 1. Definitions of appropriateness of AB RXResults  Of 5870 patients, 1856 (31.6%) had IA and 1255 (21.4%) had SO AB RX. Patients with IA/SO AB RX (47.1%) were older and more likely to have a Charlson Comorbidity Index score > 0 than those with AP&OP AB RX (52.9%;  Table 2 ). During index episode, mean ambulatory care and pharmacy claims were significantly higher for IA/SO versus AP&OP AB RX (8.0 vs 6.3, 3.3 vs 2.6, respectively; p < 0.01), and total HRU cost per patient was higher for IA/SO (&2616) versus AP&OP AB RX (&649; p < 0.01). During follow-up, 267 (9.7%) patients with IA/SO AB RX had a UTI-related emergency department (ED) visit versus 202 (6.5%) patients with AP&OP AB RX (p < 0.001). Mean UTI-related HRU costs were significantly higher for IA/SO (&5048) versus AP&OP AB RX (&3633; p = 0.01). After adjusting for patient characteristics, patients with IA/SO AB RX were 40% more likely than those with AP&OP AB RX to have a UTI-related ED visit (odds ratio 1.40; 95% confidence interval 1.15–1.71) during follow-up ( Table 3 ). Adjusted HRU costs for IA/SO AB RX (vs AP&OP) were numerically higher for index uUTI episode (by &1772), and UTI-related (by &1102) and all-cause (by &1528) charges during follow-up ( Figure ).  Table 2. Baseline characteristics of patients stratified by appropriateness of AB RXTable 3. Associations of AP&OP AB RX and HRU charges for index episode and 12-month follow-upFigure. Total 12-month UTI-related and all-cause visit charges (adjusted), stratified by appropriateness of AB RX at index and during follow-upConclusion  IA/SO AB RX was associated with higher overall and UTI-related HRU and costs during index episode and 12-month follow-up, highlighting a need for education on applying prescription guidelines and the use of culture-based RX.    Disclosures    Rena Moon, MD ,  Premier Applied Sciences, Premier Inc.  (Employee)  Alen Marijam, MSc ,  GlaxoSmithKline plc.  (Employee, Shareholder)  Fanny S. Mitrani-Gold, MPH ,  GlaxoSmithKline plc.  (Employee, Shareholder)  Daniel C. Gibbons, PhD ,  GlaxoSmithKline plc.  (Employee, Shareholder)  Alex Kartashov, PhD ,  Premier Applied Sciences, Premier Inc.  (Employee)  Ning Rosenthal, MD ,  Premier Applied Sciences, Premier Inc.  (Employee, Shareholder)  Ashish V. Joshi, PhD ,  GlaxoSmithKline plc.  (Employee, Shareholder)

open forum infectious diseases

197. Healthcare Resource Utilization and Costs Associated with Inappropriate and Suboptimal Prescribing of Antibiotics for Uncomplicated Urinary Tract Infection in the United States