Analyzing Antibiotic Usage Trends in Genitourinary Infections and Procedures: Insights from the TriNetX Database

• Published in: Urology (Ridgewood, N.J.)
• Main Authors: Im, Brian H., Hochberg, Aaron R., Havranek, Brandon, Capella, Courtney E., D’Amico, Maria J., Giordano, Analyse H., Smith, Whitney, Murphy, Alana, Shah, Mihir S., Lallas, Costas D.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 08-11-2024
• ISSN: 0090-4295; 1527-9995; 1527-9995
• DOI: 10.1016/j.urology.2024.10.071

To analyze antibiotic prescribing trends, particularly the decline in fluoroquinolone use for various GUI and procedures, and the growing preference for alternative treatments.
The TriNetX database was queried for antibiotic utilization rates from 2016 to 2022. We analyzed cases of cystitis, pyelonephritis, prostatitis, and other GUIs as well as periprocedure utilization for benign prostatic hyperplasia (BPH), urethral stricture disease, pelvic organ prolapse/stress urinary incontinence (POP/SUI), and overactive bladder/interstitial cystitis (OAB/IC). We determined the top four to six antibiotics prescribed within five days of diagnosis or procedure. Statistical analysis included linear regression modeling.
From 2016-2022, fluoroquinolone use decreased in cystitis (p<0.001), pyelonephritis (p < 0.001), and prostatitis (p < 0.01). These infections were increasingly treated with beta-lactams (p<0.0001, p<0.01, p<0.01, respectively). Additionally, we found a decrease in fluoroquinolone utilization in procedures for BPH (p<0.001), urethral stricture (p<0.01), POP/SUI (p<0.001), and OAB/IC (p < 0.001). All cohorts except for OAB/IC showed a significant increase in beta-lactam use (p<0.001, p<0.01, p<0.01, respectively).
We noted a significant decline in fluoroquinolone use for GUI and procedures, accompanied by increased beta-lactam use, reflecting changes in prescribing practices. Judicious use is essential to promote antimicrobial stewardship and mitigate severe adverse effects.