PD32-01 NATIONAL PRESCRIBING TRENDS AMONG ADULTS WITH URINARY TRACT INFECTIONS: FINDINGS FROM THE UROLOGIC DISEASES IN AMERICA PROJECT

Abstract

INTRODUCTION AND OBJECTIVE: Concerns of multidrug resistance may be influencing prescribing practices for urinary tract infections (UTI). We assessed 10-year trends in pharmacotherapy for UTI among a large sample of US adults treated in outpatient settings. METHODS: We assessed trends in the prevalence of UTIrelated prescription fills and medication duration from 2007-2016. To assess trends among those aged 18-64 years (N= 2,691,529 UTI episodes), we utilized the Optum © Clinformatics® Data Mart (CDM), a de-identified administrative claims database that includes individuals covered by commercial insurance in all 50 US states. For analyses among those aged ≥65 years (N=874,043 UTI episodes), we utilized the Medicare 5% Sample. UTI was defined as an outpatient claim with a UTI-related diagnosis code followed by a pharmacy claim for an anti-infectious agent within 72 hours. RESULTS: The most commonly used medications were quinolones, urinary anti-infectives, and sulfonamides (Table 1). Quinolone use was more common among men compared to women, while urinary anti-infective use was more common among women. The mean duration of medication use was 8 days, with variation by medication type (range: 5-16 days). Over time, quinolone use decreased while the use of urinary anti-infectives, cephalosporins, and combination therapy including azoles increased (Figure 1). CONCLUSIONS: Pharmacological treatment of UTI evolved over the 10-year study period, shifting from a primarily quinolone-based treatment paradigm to a more diverse pharmaceutical armamentarium that increasingly relied on cephalosporin agents. This evolution was likely driven by resistance patterns that particularly impact the effectiveness of quinolone agents. Nevertheless, regardless of the antibacterial agent used, treatment duration appeared to be longer than what guidelines typically suggest, representing an opportunity for practice improvement. (Figure Presented).