Factors Associated with the Duration of Symptoms in Adult Women with Suspected Cystitis in Primary Care

Mathilde François (1) , Barbara Clais (2) , Thierry Blanchon (3) , Cécile Souty (3) , Thomas Hanslik (1, 4) , Louise Rossignol (3)

1 CESP - Centre de recherche en épidémiologie et santé des populations
2 UPD5 Médecine - Université Paris Descartes - Faculté de Médecine
3 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
4 Hôpital Ambroise Paré [AP-HP]

Objective: The aim of this study was to identify factors associated to the duration of symptoms of cystitis. Patients and methods: We conducted a nested survival study using Druti study data. Druti was a cross-sectional survey conducted in adult women visiting a general practitioner in France, for a suspected urinary tract infection between January 2012 and February 2013. For this study, urine cultures were systematically performed for all women. The evolution of symptoms were monitored daily for two weeks. This nested study considered only women with suspected cystitis from Druti; women with pyelonephritis were excluded. To identify independent predictors for duration of symptoms, a Cox proportional hazards regression model was performed. Results: In Druti, 449 patients had a suspected cystitis. Among them, 440 had a follow up at two weeks. Out of the 440 patients, 424 had a prescription of antibiotic treatment (96.4%). The urine culture was positive for 326 patients (74.1%). The median duration of symptoms after consultation was two days (interquartile 1-3). The absence of urinary frequency (median two days versus three days, p = 0.008), age over 55 years (median two days versus three days, p<0.001) and patient's bet about the presence of a urinary tract infection (median two days, p = 0.021) were associated to a longer duration of symptoms. Positive culture (p = 0.99) and presence of a multi-drug resistant organism (p = 0.38) did not influence the duration of symptoms. Conclusion: In a real-life study, factors influencing the duration of symptoms are clinical factors. The delay before re-evaluation in case of persistent symptoms after treatment could be adapted according to the initial clinical examination.

Domaines: Sciences du Vivant [q-bio]

Mathilde François, Barbara Clais, Thierry Blanchon, Cécile Souty, Thomas Hanslik, et al.. Factors Associated with the Duration of Symptoms in Adult Women with Suspected Cystitis in Primary Care. PLoS ONE, 2018, 13 (7), pp.e0201057. ⟨10.1371/journal.pone.0201057⟩. ⟨hal-03888709⟩