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Article ; Online: Acute cystitis in men- a nationwide study from primary care: antibiotic prescriptions, risk factors, and complications.

Sætre, Håkon / Skow, Marius / Vik, Ingvild / Høye, Sigurd / Emilsson, Louise

BJGP open

2024

Abstract: Background: Research on acute cystitis in men is scarce and treatment guidelines differ between countries. Improved antibiotic stewardship is needed.: Aim: To analyse antibiotic prescriptions and outcomes of Norwegian men diagnosed with cystitis in ... ...

Abstract	Background: Research on acute cystitis in men is scarce and treatment guidelines differ between countries. Improved antibiotic stewardship is needed. Aim: To analyse antibiotic prescriptions and outcomes of Norwegian men diagnosed with cystitis in primary care. Design & setting: A nationwide retrospective study was undertaken in primary care in Norway. Method: We identified all episodes of acute cystitis in men diagnosed in Norwegian primary care during 2012-2019. Choice of antibiotic (from the Norwegian Prescription Database), treatment failure, re-prescription, and complications were stratified by age, calendar year, and risk factors. We used logistic regression to explore predefined risk factors (diabetes, prostate cancer, benign prostate hyperplasia [BPH], urinary retention, and any cancer) with complications (pyelonephritis, prostatitis, and hospitalisation) and re-prescriptions. Linear regression was used to explore time trends. Results: In total, 108 994 individuals contributed 148 635 episodes. Narrow-spectrum antibiotics were first-choice treatment in 71.0% of the episodes (52.5% of all prescriptions were pivmecillinam). More than 75% of the episodes with narrow-spectrum versus 82.2% of broad-spectrum treatment did not lead to any re-prescription or complication. Complications occurred in 1.8% of all episodes (0.5% prostatitis, 0.7% pyelonephritis, and 0.7% hospitalisation). BPH was associated with increased risk of complications and re-prescription. Diabetes was associated with a lower risk of re-prescriptions. Prostate cancer and urinary retention were associated with a lower risk of both complications and re-prescriptions. Conclusion: Our results support narrow-spectrum antibiotics as first-line treatment. Risk factor analyses warrants further investigation.
Language	English
Publishing date	2024-04-30
Publishing country	England
Document type	Journal Article
ISSN	2398-3795
ISSN (online)	2398-3795
DOI	10.3399/BJGPO.2023.0207
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Article ; Online: Antibiotic switch after treatment with UTI antibiotics in male patients.

Skow, Marius A H / Vik, Ingvild / Høye, Sigurd

Infectious diseases (London, England)

2020 Volume 52, Issue 6, Page(s) 405–412

Abstract: Background: ...

Abstract	Background:
MeSH term(s)	Amdinocillin Pivoxil/therapeutic use ; Anti-Bacterial Agents/therapeutic use ; Cephalexin/therapeutic use ; Drug Substitution ; Fluoroquinolones/therapeutic use ; Humans ; Male ; Middle Aged ; Nitrofurantoin/therapeutic use ; Trimethoprim, Sulfamethoxazole Drug Combination/therapeutic use ; Urinary Tract Infections/drug therapy
Chemical Substances	Anti-Bacterial Agents ; Fluoroquinolones ; Amdinocillin Pivoxil (1WAM1OQ30B) ; Trimethoprim, Sulfamethoxazole Drug Combination (8064-90-2) ; Nitrofurantoin (927AH8112L) ; Cephalexin (OBN7UDS42Y)
Language	English
Publishing date	2020-03-14
Publishing country	England
Document type	Journal Article
ZDB-ID	2839775-7
ISSN	2374-4243 ; 2374-4235
ISSN (online)	2374-4243
ISSN	2374-4235
DOI	10.1080/23744235.2020.1736329
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Article: The Risk of Pyelonephritis Following Uncomplicated Cystitis: A Nationwide Primary Healthcare Study.

Jansåker, Filip / Li, Xinjun / Vik, Ingvild / Frimodt-Møller, Niels / Knudsen, Jenny Dahl / Sundquist, Kristina

Antibiotics (Basel, Switzerland)

2022 Volume 11, Issue 12

Abstract: Background: The risk of pyelonephritis following uncomplicated lower urinary tract infection (cystitis) in women has not been studied in well-powered samples. This is likely due to the previous lack of nationwide primary healthcare data. We aimed to ... ...

Abstract	Background: The risk of pyelonephritis following uncomplicated lower urinary tract infection (cystitis) in women has not been studied in well-powered samples. This is likely due to the previous lack of nationwide primary healthcare data. We aimed to examine the risks of pyelonephritis following cystitis in women and explore if antibiotic treatment, cervical cancer, parity, and sociodemographic factors are related to these risks. Methods: This was a nationwide cohort study (2006-2018) of 752,289 women diagnosed with uncomplicated cystitis in primary healthcare settings. Of these, 404 696 did not redeem an antibiotic prescription within five days from cystitis. Logistic regression models were used to calculate odds ratios for pyelonephritis within 30 days and 90 days following the cystitis event. Results: Around one percent (7454) of all women with cystitis were diagnosed with pyelonephritis within 30 days, of which 78.2% had not redeemed an antibiotic for their cystitis. Antibiotic treatment was inversely associated with both outpatient registration and hospitalization due to pyelonephritis, with odds ratios of 0.85 (95% CI 0.80 to 0.91) and 0.65 (95% CI 0.55 to 0.77), respectively. Sociodemographic factors, parity, and cervical cancer were, with few exceptions (e.g., age and region of residency), not associated with pyelonephritis. Conclusions: Antibiotic treatment was inversely associated with pyelonephritis, but the absolute risk reduction was low. Non-antibiotic treatment for cystitis might be a safe option for most women. Future studies identifying the women at the highest risks will help clinicians in their decision making when treating cystitis, while keeping the ecological costs of antibiotics in mind.
Language	English
Publishing date	2022-11-24
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2681345-2
ISSN	2079-6382
ISSN	2079-6382
DOI	10.3390/antibiotics11121695
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Article ; Online: Women's experiences and views on early breastfeeding during the COVID-19 pandemic in Norway: quantitative and qualitative findings from the IMAgiNE EURO study.

Vik, Eline Skirnisdottir / Kongslien, Sigrun / Nedberg, Ingvild Hersoug / Mariani, Ilaria / Valente, Emanuelle Pessa / Covi, Benedetta / Lazzerini, Marzia

International breastfeeding journal

2023 Volume 18, Issue 1, Page(s) 15

Abstract: Background: Little is known about women's experience of care and views on early breastfeeding during the COVID-19 pandemic in Norway.: Methods: Women (n = 2922) who gave birth in a facility in Norway between March 2020 and June 2021 were invited to ... ...

Abstract	Background: Little is known about women's experience of care and views on early breastfeeding during the COVID-19 pandemic in Norway. Methods: Women (n = 2922) who gave birth in a facility in Norway between March 2020 and June 2021 were invited to answer an online questionnaire based on World Health Organization (WHO) Standard-based quality measures, exploring their experiences of care and views on early breastfeeding during the COVID-19 pandemic. To examine associations between year of birth (2020, 2021) and early breastfeeding-related factors, we estimated odds ratios (ORs) with 95% confidence intervals (CIs) using multiple logistic regression. Qualitative data were analysed using Systematic Text Condensation. Results: Compared to the first year of the pandemic (2020), women who gave birth in 2021 reported higher odds of experiencing adequate breastfeeding support (adjOR 1.79; 95% CI 1.35, 2.38), immediate attention from healthcare providers when needed (adjOR 1.89; 95% CI 1.49, 2.39), clear communication from healthcare providers (adjOR 1.76; 95% CI 1.39, 2.22), being allowed companion of choice (adjOR 1.47; 95% CI 1.21, 1.79), adequate visiting hours for partner (adjOR 1.35; 95% CI 1.09, 1.68), adequate number of healthcare providers (adjOR 1.24; 95% CI 1.02, 1.52), and adequate professionalism of the healthcare providers (adjOR 1.65; 95% CI 1.32, 2.08). Compared to 2020, in 2021 we found no difference in skin-to-skin contact, early breastfeeding, exclusive breastfeeding at discharge, adequate number of women per room, or women's satisfaction. In their comments, women described understaffed postnatal wards, early discharge and highlighted the importance of breastfeeding support, and concerns about long-term consequences such as postpartum depression. Conclusions: In the second year of the pandemic, WHO Standard-based quality measures related to breastfeeding improved for women giving birth in Norway compared to the first year of the pandemic. Women's general satisfaction with care during COVID-19 did however not improve significantly from 2020 to 2021. Compared to pre-pandemic data, our findings suggest an initial decrease in exclusive breastfeeding at discharge during the COVID-19 pandemic in Norway with little difference comparing 2020 versus 2021. Our findings should alert researchers, policy makers and clinicians in postnatal care services to improve future practices.
MeSH term(s)	Pregnancy ; Female ; Humans ; Breast Feeding ; Pandemics ; COVID-19/epidemiology ; Parturition ; Norway/epidemiology
Language	English
Publishing date	2023-03-10
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2227239-2
ISSN	1746-4358 ; 1746-4358
ISSN (online)	1746-4358
ISSN	1746-4358
DOI	10.1186/s13006-023-00553-5
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Article ; Online: Quality of health care around the time of childbirth during the COVID-19 pandemic: Results from the IMAgiNE EURO study in Norway and trends over time.

Nedberg, Ingvild Hersoug / Vik, Eline Skirnisdottir / Kongslien, Sigrun / Mariani, Ilaria / Valente, Emanuelle Pessa / Covi, Benedetta / Lazzerini, Marzia

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

2022 Volume 159 Suppl 1, Page(s) 85–96

Abstract: Objective: To describe maternal perception of the quality of maternal and newborn care (QMNC) in facilities in Norway during the first year of COVID-19 pandemic.: Methods: Women who gave birth in a Norwegian facility from March 1, 2020, to October 28, ...

Abstract	Objective: To describe maternal perception of the quality of maternal and newborn care (QMNC) in facilities in Norway during the first year of COVID-19 pandemic. Methods: Women who gave birth in a Norwegian facility from March 1, 2020, to October 28, 2021, filled out a structured online questionnaire based on 40 WHO standards-based quality measures. Quantile regression analysis was performed to assess changes in QMNC index over time. Results: Among 3326 women included, 3085 experienced labor. Of those, 1799 (58.3%) reported that their partner could not be present as much as needed, 918 (29.8%) noted inadequate staff numbers, 183 (43.6%) lacked a consent request for instrumental vaginal birth (IVB), 1067 (34.6%) reported inadequate communication from staff, 78 (18.6%) reported fundal pressure during IVB, 670 (21.7%) reported that they were not treated with dignity, and 249 (8.1%) reported experiencing abuse. The QMNC index increased gradually over time (3.68 points per month, 95% CI, 2.83-4.53 for the median), with the domains of COVID-19 reorganizational changes and experience of care displaying the greatest increases, while provision of care was stable over time. Conclusion: Although several measures showed high QMNC in Norway during the first year of the COVID-19 pandemic, and a gradual improvement over time, several findings suggest that gaps in QMNC exist. These gaps should be addressed and monitored.
MeSH term(s)	Pregnancy ; Infant, Newborn ; Female ; Humans ; Pandemics ; COVID-19/epidemiology ; Delivery, Obstetric ; Parturition ; Maternal Health Services ; Quality of Health Care
Language	English
Publishing date	2022-12-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	80149-5
ISSN	1879-3479 ; 0020-7292
ISSN (online)	1879-3479
ISSN	0020-7292
DOI	10.1002/ijgo.14460
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Article ; Online: Predictors of Symptom Duration and Bacteriuria in Uncomplicated Urinary Tract Infection.

Bollestad, Marianne / Vik, Ingvild / Grude, Nils / Lindbæk, Morten

Scandinavian journal of primary health care

2018 Volume 36, Issue 4, Page(s) 446–454

Abstract: Objective: To identify baseline predictors of symptom duration after empirical treatment for uncomplicated urinary tract infection (UTI) and significant bacteriuria in a cohort of women treated for UTI.: Design: Prospective single-centre cohort study. ...

Abstract	Objective: To identify baseline predictors of symptom duration after empirical treatment for uncomplicated urinary tract infection (UTI) and significant bacteriuria in a cohort of women treated for UTI. Design: Prospective single-centre cohort study. Setting: Outpatient clinic in Norway. Patients: From September 2010 to November 2011, 441 women aged 16-55 years with symptoms of uncomplicated UTI were included. Results: Dipstick findings of leukocyte esterase 1 + (incidence rate ratio (IRR) 1.93, 95% confidence interval (CI) 1.23-3.01, p < 0.01) and microbe resistant to mecillinam treatment (IRR 1.41, 95% CI 1.07-1.89, p = 0.02) predicted longer symptom duration. More pronounced symptoms did not predict longer symptom duration (IRR 1.18, 95% CI 0.94-1.46, p = 0.15) or significant bacteriuria (odds ratio [OR] 1.16, 95% CI 0.72-1.88, p = 0.54). Leukocyte esterase 2 + (OR 2.51, 95% CI 0.92-6.83, p = 0.07) or 3 + (OR 2.40, 95% CI 0.88-6.05, p = 0.09) and nitrite positive urine dipstick test (OR 3.22, 95% CI 1.58-7.01, p = <0.01) were associated with bacteriuria. Conclusion: More pronounced symptoms did not correlate with significant bacteriuria or symptom duration after empirical treatment for acute cystitis. One might reconsider the current practice of treating uncomplicated UTI based on symptoms alone. Key Points Treatment strategies for milder infectious diseases must consider ways of reducing antibiotic consumption to decelerate the increase in antibiotic resistance. Our findings suggest that more emphasis should be put on urine dipstick results and bacteriological findings in the clinical setting. One might reconsider the current practice of treating uncomplicated UTIs based on symptoms alone.
MeSH term(s)	Acute Disease ; Adolescent ; Adult ; Anti-Bacterial Agents/therapeutic use ; Bacteriuria/diagnosis ; Bacteriuria/drug therapy ; Cystitis/drug therapy ; Drug Resistance, Microbial ; Female ; Humans ; Logistic Models ; Middle Aged ; Norway ; Predictive Value of Tests ; Prospective Studies ; Risk Factors ; Time Factors ; Urinalysis/methods ; Urinary Tract Infections/diagnosis ; Urinary Tract Infections/drug therapy ; Young Adult
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2018-09-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	605763-9
ISSN	1502-7724 ; 0281-3432 ; 0284-6020
ISSN (online)	1502-7724
ISSN	0281-3432 ; 0284-6020
DOI	10.1080/02813432.2018.1499602
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Article ; Online: Predictors of Symptom Duration and Bacteriuria in Uncomplicated Urinary Tract Infection

Marianne Bollestad / Ingvild Vik / Nils Grude / Morten Lindbæk

Scandinavian Journal of Primary Health Care, Vol 36, Iss 4, Pp 446-

2018 Volume 454

Abstract: Objective: To identify baseline predictors of symptom duration after empirical treatment for uncomplicated urinary tract infection (UTI) and significant bacteriuria in a cohort of women treated for UTI. Design: Prospective single-centre cohort study. ... ...

Abstract	Objective: To identify baseline predictors of symptom duration after empirical treatment for uncomplicated urinary tract infection (UTI) and significant bacteriuria in a cohort of women treated for UTI. Design: Prospective single-centre cohort study. Setting: Outpatient clinic in Norway. Patients: From September 2010 to November 2011, 441 women aged 16–55 years with symptoms of uncomplicated UTI were included. Results: Dipstick findings of leukocyte esterase 1 + (incidence rate ratio (IRR) 1.93, 95% confidence interval (CI) 1.23–3.01, p < 0.01) and microbe resistant to mecillinam treatment (IRR 1.41, 95% CI 1.07–1.89, p = 0.02) predicted longer symptom duration. More pronounced symptoms did not predict longer symptom duration (IRR 1.18, 95% CI 0.94–1.46, p = 0.15) or significant bacteriuria (odds ratio [OR] 1.16, 95% CI 0.72–1.88, p = 0.54). Leukocyte esterase 2 + (OR 2.51, 95% CI 0.92–6.83, p = 0.07) or 3 + (OR 2.40, 95% CI 0.88–6.05, p = 0.09) and nitrite positive urine dipstick test (OR 3.22, 95% CI 1.58–7.01, p = <0.01) were associated with bacteriuria. Conclusion: More pronounced symptoms did not correlate with significant bacteriuria or symptom duration after empirical treatment for acute cystitis. One might reconsider the current practice of treating uncomplicated UTI based on symptoms alone.Key Points Treatment strategies for milder infectious diseases must consider ways of reducing antibiotic consumption to decelerate the increase in antibiotic resistance. Our findings suggest that more emphasis should be put on urine dipstick results and bacteriological findings in the clinical setting. One might reconsider the current practice of treating uncomplicated UTIs based on symptoms alone.
Keywords	Primary health care ; urinary tract infection ; after-hours care ; bacteriuria ; female urogenital diseases ; Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2018-10-01T00:00:00Z
Publisher	Taylor & Francis Group
Document type	Article ; Online
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Article: Pivmecillinam for Uncomplicated Lower Urinary Tract Infections Caused by

Jansåker, Filip / Bollestad, Marianne / Vik, Ingvild / Lindbæk, Morten / Bjerrum, Lars / Frimodt-Møller, Niels / Knudsen, Jenny Dahl

Antibiotics (Basel, Switzerland)

2019 Volume 8, Issue 2

Abstract: ... ...

Abstract	Objectives
Language	English
Publishing date	2019-05-07
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2681345-2
ISSN	2079-6382
ISSN	2079-6382
DOI	10.3390/antibiotics8020057
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Article ; Online: Treatment of uncomplicated UTI in males: a systematic review of the literature.

Farrell, Karen / Tandan, Meera / Hernandez Santiago, Virginia / Gagyor, Ildiko / Braend, Anja Maria / Skow, Marius / Vik, Ingvild / Jansaaker, Filip / Hayward, Gail / Vellinga, Akke

BJGP open

2021 Volume 5, Issue 2

Abstract: Background: Urinary tract infections (UTIs) affect around 20% of the male population in their lifetime. The incidence of UTIs in men in the community is 0.9-2.4 cases per 1000 aged <55 years and 7.7 per 1000 aged ≥85 years.: Aim: To evaluate the ... ...

Abstract	Background: Urinary tract infections (UTIs) affect around 20% of the male population in their lifetime. The incidence of UTIs in men in the community is 0.9-2.4 cases per 1000 aged <55 years and 7.7 per 1000 aged ≥85 years. Aim: To evaluate the outcomes of randomised controlled trials (RCTs) comparing the effectiveness of different antimicrobial treatments and durations for uncomplicated UTIs in adult males in outpatient settings. Method: A systematic literature review of RCTs of adult male patients with an uncomplicated UTI treated with oral antimicrobials in any outpatient setting. The outcomes were symptom resolution within 2 weeks of starting treatment, duration until symptom resolution, clinical cure, bacteriological cure, and frequency of adverse events. Results: From the 1052 abstracts screened, three provided sufficient information on outcomes. One study compared trimethoprim-sulfamethoxazole for 14 days (21 males) with 42 days (21 males). Fluoroquinolones were compared in the two other RCTs: lomefloxacin (10 males) with norfloxacin (11 males), and ciprofloxacin for 7 days (19 males) and 14 days (19 males). Combining the results from the three RCTs shows that for 75% males with a UTI (76/101) bacteriological cure was reported at the end of the study. Of the 59 patients receiving a fluoroquinolone, 57 (97%) reported bacteriological and clinical cure within 2 weeks after treatment. Conclusion: The evidence available is insufficient to make any recommendations in relation to type and duration of antimicrobial treatment for male UTIs. Sufficiently powered RCTs are needed to identify best treatment type and duration for male UTIs in primary care.
Language	English
Publishing date	2021-04-26
Publishing country	England
Document type	Journal Article
ISSN	2398-3795
ISSN (online)	2398-3795
DOI	10.3399/bjgpopen20X101140
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Article ; Online: Reducing antibiotic use in uncomplicated urinary tract infections in adult women: a systematic review and individual participant data meta-analysis.

Kaußner, Yvonne / Röver, Christian / Heinz, Judith / Hummers, Eva / Debray, Thomas P A / Hay, Alastair D / Heytens, Stefan / Vik, Ingvild / Little, Paul / Moore, Michael / Stuart, Beth / Wagenlehner, Florian / Kronenberg, Andreas / Ferry, Sven / Monsen, Tor / Lindbæk, Morten / Friede, Tim / Gágyor, Ildikó

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

2022 Volume 28, Issue 12, Page(s) 1558–1566

Abstract: Background: Randomised controlled trials (RCTs) investigated analgesics, herbal formulations, delayed prescription of antibiotics, and placebo to prevent overprescription of antibiotics in women with uncomplicated urinary tract infections (uUTI).: ... ...

Abstract	Background: Randomised controlled trials (RCTs) investigated analgesics, herbal formulations, delayed prescription of antibiotics, and placebo to prevent overprescription of antibiotics in women with uncomplicated urinary tract infections (uUTI). Objectives: To estimate the effect of these strategies and to identify symptoms, signs, or other factors that indicate a benefit from these strategies. Data sources: MEDLINE, EMBASE, Web of Science, LILACS, Cochrane Database of Systematic Reviews and of Controlled Trials, and ClinicalTrials. Study eligibility criteria, participants and interventions: RCTs investigating any strategies to reduce antibiotics vs. immediate antibiotics in adult women with uUTI in primary care. Methods: We extracted individual participant data (IPD) if available, otherwise aggregate data (AD). Bayesian random-effects meta-analysis of the AD was used for pairwise comparisons. Candidate moderators and prognostic indicators of treatment effects were investigated using generalised linear mixed models based on IPD. Results: We analysed IPD of 3524 patients from eight RCTs and AD of 78 patients. Non-antibiotic strategies increased the rates of incomplete recovery (OR 3.0; 95% credible interval (CrI), 1.7-5.5; Bayesian p-value (p Conclusions: Compared to immediate antibiotics, non-antibiotic strategies reduce overall antibiotic use but result in poorer clinical outcomes. The presence of erythrocytes and tests to confirm bacteria in urine could be used to target antibiotic prescribing.
MeSH term(s)	Female ; Adult ; Humans ; Anti-Bacterial Agents ; Urinary Tract Infections/drug therapy ; Urinary Tract Infections/prevention & control ; Pyelonephritis/drug therapy
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2022-07-02
Publishing country	England
Document type	Meta-Analysis ; Journal Article ; Review ; Systematic Review
ZDB-ID	1328418-6
ISSN	1469-0691 ; 1470-9465 ; 1198-743X
ISSN (online)	1469-0691
ISSN	1470-9465 ; 1198-743X
DOI	10.1016/j.cmi.2022.06.017
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