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Predictors of receipt of a fluoroquinolone versus trimethoprim‐sulfamethoxazole for treatment of acute pyelonephritis in women in Manitoba, Canada
Author(s) -
Carrie Anita G.,
Metge Colleen J.,
Collins David M.,
Harding Godfrey K. M.,
Zhanel George G.
Publication year - 2004
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.949
Subject(s) - medicine , pharmacoepidemiology , receipt , trimethoprim , sulfamethoxazole , intensive care medicine , emergency medicine , antibiotics , pharmacology , medical prescription , microbiology and biotechnology , world wide web , computer science , biology
Abstract Purpose The increasing and comparatively high proportion of uropathogens in Canada resistant to trimethoprim‐sulfamethoxazole (TMP‐SMX) may be partially responsible for the increasing use of fluoroquinolones. A number of patient‐specific variables have been identified as risk factors for infections caused by antibiotic‐resistant pathogens. However, variables unrelated to need, have also been associated with receipt of broad‐spectrum antibiotics. We identified patient variables associated with receipt of a fluoroquinolone versus TMP‐SMX for treatment of acute pyelonephritis. Methods Healthcare claims from the province of Manitoba, Canada for the period February 1996 to March 1999 were examined to identify episodes of pyelonephritis in non‐pregnant females between 18 and 65 years of age treated with TMP‐SMX or a fluoroquinolone. Patient variables were identified based on healthcare claims review and data from Statistics Canada. Logistic regression was used to model the probability of receipt of a fluoroquinolone. Results A total of 1084 women met inclusion criteria; 653 treated with TMP‐SMX and 431 treated with a fluoroquinolone. Age, income, rural residence, recent antibiotic use, recent hospitalization and presentation to an emergency room (ER) were positively associated with receipt of a fluoroquinolone. Conclusions Patient variables reportedly associated with an increased probability of resistant organisms (e.g., age, recent antibiotic use and recent hospitalization) were significantly associated with an increased probability of receipt of fluoroquinolones. However, variables unrelated to antibiotic resistance (e.g., income, rural residence and presentation to an ER) were also significantly associated with receipt of a fluoroquinolone. Copyright © 2004 John Wiley & Sons, Ltd.