Multiple sclerosis (MS) is a disease where the immune system disturbs messages in the brain and spinal cord. People with MS often get more urinary tract infections (UTIs) than most people. Like people with MS, people with rheumatoid arthritis (RA, a condition where a person's immune system mistakenly attacks their own joints) and diabetes mellitus (DM, a condition where the body has trouble controlling the level of sugar in the blood) also get more UTIs. The UK guidelines for treating UTIs are the same for everyone, whether they have MS, RA, DM, or not. We don't know if doctors treat UTIs differently in people with these conditions compared to others.
This study aims to compare how UTIs are treated in people with MS, RA, DM, and the general population. We will look at whether the treatment changes between new and repeated UTIs and if people with MS need to switch antibiotics more often and get more repeated UTIs. The results might show if the choice of antibiotic affects how often people with MS get UTIs again.The study may inform more effective antibiotic management of infections, which is of benefit to the public in light of better patient care and in light of preventing antimicrobial resistance to antibiotics.
Multiple sclerosis (MS) is a chronic demyelinating disease. People with MS have a higher risk of urinary tract infection (UTI) than the general population. Similar to people with MS, people with rheumatoid arthritis (RA) and diabetes mellitus (DM) are at greater risk of UTI, and there are no guidelines for the treatment of UTI specifically for these populations. The aim of this study is to compare treatment patterns for UTI among people with MS to that among people with RA, DM, and the general population. As secondary objective, we will investigate whether MS is associated with antibiotic switch for UTI and UTI recurrence. The unit of analysis in this study will be GP-recorded UTI episode; the study ‘population’ will include UTIs from everyone with a UTI between 1 April 2022 and 31 March 2023. We will (1) provide descriptive statistics on the treatment of UTI and (2) conduct a conditional logistic regression analysis on the association between MS and antibiotic switch in the treatment of UTI, and a conditional logistic regression analysis on the association between MS and UTI recurrence. The intended public health benefit is that the findings may inform treatment of UTI with lower probability of recurrence.
UTI-related events: recorded diagnoses and symptoms, antibiotic prescriptions, and urinary cultures
Ewoudt van de Garde - Chief Investigator - Utrecht University
Patrick Souverein - Corresponding Applicant - Utrecht University
Bernard Uitdehaag - Collaborator - VU Medical Centre
Marloes Bazelier - Collaborator - Utrecht University
Melissa Leung - Collaborator - Utrecht University
Olaf Klungel - Collaborator - Utrecht University
Practice Level Index of Multiple Deprivation