Höller Martina, Steindl Hubert, Abramov-Sommariva Dimitri, Wagenlehner Florian, Naber Kurt G, Kostev Karel
Bionorica SE, Kerschensteinerstr. 11-15, 92318 Neumarkt, Germany.
Clinic for Urology, Pediatric Urology and Andrology, Justus-Liebig University, Giessen, Rudolf-Buchheim-Straße 7, 35392 Giessen, Germany.
Antibiotics (Basel). 2021 Jun 8;10(6):685. doi: 10.3390/antibiotics10060685.
The goal of the present study was to evaluate treatment with Canephron compared to standard antibiotic treatment after diagnosis of acute cystitis or urinary tract infection (UTI), with regard to the risk of sporadic recurrent UTIs, frequent recurrent UTIs, UTI-related sick leave, additional antibiotic prescriptions, and renal complications (pyelonephritis). This retrospective cohort study was based on data from the IMS Disease Analyzer database (IQVIA), and included outpatients in Germany with at least one diagnosis of acute cystitis or UTI with a prescription of either Canephron or standard antibiotics between January 2016 and June 2019 and treated in general practitioner (GP), gynecologist, or urologist practices, from which the data were obtained. Multivariable regression models were used to investigate the association between Canephron prescription and the amount of sporadic or frequent recurrent UTIs, as well as the duration of UTI-related sick leave, the number of additional antibiotic prescriptions, and cases of pyelonephritis. The effects of Canephron were adjusted for age, sex, insurance status, and Charlson comorbidity score (CCI). 2320 Canephron patients and 158,592 antibiotic patients were available for analysis. Compared to antibiotic prescription, Canephron prescription was significantly associated with fewer sporadic recurrences of UTI infections 30-365 days after the index date (odds ratio (OR): 0.66; 95%, confidence interval (CI): 0.58-0.72), as well as less frequent recurrences of UTI infections (OR: 0.61; 95% CI: 0.49-0.88), and also with reduced additional antibiotic prescription within 31-365 days (OR: 0.57; 95% CI: 0.52-0.63). No significant differences were observed between the Canephron and antibiotic cohorts with regard to the likelihood of sick leave (OR: 0.99; 95% CI: 0.86-1.14), new antibiotic prescription within 1-30 days (OR: 1.01; 95% CI: 0.87-1.16), or occurrence of pyelonephritis (Hazard Ratio (HR): 1.00; 95% CI: 0.67-1.48). These real-world data show that Canephron is an effective, safe symptomatic treatment for acute cystitis or UTI. It should be considered as an alternative treatment, particularly to also strengthen antimicrobial stewardship strategies.
本研究的目的是评估与急性膀胱炎或尿路感染(UTI)诊断后的标准抗生素治疗相比,使用Canephron治疗在散发性复发性UTI、频繁复发性UTI、UTI相关病假、额外抗生素处方以及肾脏并发症(肾盂肾炎)风险方面的情况。这项回顾性队列研究基于IMS疾病分析器数据库(IQVIA)的数据,纳入了2016年1月至2019年6月期间在德国至少有一次急性膀胱炎或UTI诊断且开具了Canephron或标准抗生素处方并在全科医生(GP)、妇科医生或泌尿科医生诊所接受治疗的门诊患者,数据即从这些诊所获取。使用多变量回归模型来研究Canephron处方与散发性或频繁复发性UTI的数量、UTI相关病假的时长、额外抗生素处方的数量以及肾盂肾炎病例之间的关联。对Canephron的效果进行了年龄、性别、保险状况和查尔森合并症评分(CCI)的调整。共有2320名Canephron患者和158592名抗生素治疗患者可供分析。与抗生素处方相比,Canephron处方与索引日期后30 - 365天UTI感染的散发性复发显著减少相关(优势比(OR):0.66;95%,置信区间(CI):0.58 - 0.72),以及UTI感染的复发频率降低相关(OR:0.61;95% CI:0.49 - 0.88),并且在31 - 365天内额外抗生素处方也减少(OR:0.57;95% CI:0.52 - 0.63)。在病假可能性(OR:0.99;95% CI:0.86 - 1.14)、1 - 30天内新的抗生素处方(OR:1.01;95% CI:0.87 - 1.16)或肾盂肾炎的发生(风险比(HR):1.00;95% CI:0.67 - 1.48)方面,Canephron组和抗生素组之间未观察到显著差异。这些真实世界数据表明,Canephron是治疗急性膀胱炎或UTI的一种有效、安全的对症治疗方法。应将其视为一种替代治疗方法,特别是为了加强抗菌管理策略。