Effect of methenamine hippurate shortage on antibiotic prescribing for urinary tract infections in Norway-an interrupted time series analysis.

Autor:	Heltveit-Olsen SR; The Antibiotic Centre for Primary Care, Department of General Practice, Institute of Health and Society, University of Oslo, Fredrik Holst house, PB 1130 Blindern, 0318 Oslo, Norway., Gopinathan U; Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway., Blix HS; Department of Antibiotic Resistance and Infection Prevention, Norwegian Institute of Public Health, Oslo, Norway., Elstrøm P; Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway., Høye S; The Antibiotic Centre for Primary Care, Department of General Practice, Institute of Health and Society, University of Oslo, Fredrik Holst house, PB 1130 Blindern, 0318 Oslo, Norway.
Jazyk:	angličtina
Zdroj:	The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2024 May 02; Vol. 79 (5), pp. 1109-1117.
DOI:	10.1093/jac/dkae078
Abstrakt:	Background: Despite a lack of conclusive evidence of effect, methenamine hippurate is widely prescribed as preventive treatment for recurrent urinary tract infections (UTIs) in Norway. A national discontinuation of methenamine hippurate treatment due to a 4-month drug shortage in 2019 presented an opportunity to evaluate its preventive effect on UTIs among regular users. Objective: To estimate the impact of the methenamine hippurate drug shortage on prescription frequency of UTI antibiotics. Methods: Data from The Norwegian Prescription Database was analysed using an interrupted time series design. The time series consisted of 56 time periods of 14 days. The model included two naturally occurring interruptions: (i) the methenamine hippurate drug shortage, and (ii) reintroduction of the drug. The study population were 18 345 women ≥50 years receiving ≥2 prescriptions of methenamine hippurate in the study period before the shortage. Main outcome measure was number of prescriptions of UTI antibiotics per 1000 methenamine hippurate users. Prescription rates of antibiotics for respiratory tract infections were analysed to assess external events affecting antibiotic prescribing patterns. Results: We found a significant increase of 2.41 prescriptions per 1000 methenamine hippurate users per 14-day period during the drug shortage (95%CI 1.39, 3.43, P < 0.001), followed by a significant reduction of -2.64 prescriptions after reintroduction (95%CI -3.66, -1.63, P < 0.001). Conclusions: During the methenamine hippurate drug shortage, we found a significant increase in prescribing trend for UTI antibiotics followed by a significant decrease in prescribing trend after reintroduction. This change in trend seems to reflect a preventive effect of the drug on recurrent UTIs. (© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.)
Databáze:	MEDLINE
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