Microorganisms (Feb 2025)

Evaluation and Analysis of Costs Associated with Prophylaxis of Recurrent Urinary Tract Infections (RUTIs) in Women

  • José Emilio Hernández-Sánchez,
  • Julius Jan Szczesnieski,
  • Bárbara-Yolanda Padilla-Fernández,
  • Carmen González-Enguita,
  • Javier Flores-Fraile,
  • María Fernanda Lorenzo-Gómez

DOI
https://doi.org/10.3390/microorganisms13020393
Journal volume & issue
Vol. 13, no. 2
p. 393

Abstract

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To determine the variations in the costs of the prophylaxis of recurrent urinary tract infections (RUTIs) among different prevention protocols, a prospective observational multicenter study on 1614 women receiving RUTI prophylaxis was conducted. The patient groups were as follows: Group A (n = 444): conventional suppressive antibiotic therapy; Group V (n = 732): polyvalent bacterial vaccine; and Group O (n = 438): other adjuvant measures. The variables were age, body mass index, American Society of Anesthesiologists (ASA) physical status classification scale, cost of prophylaxis, duration of the RUTI, number of visits for primary and specialized care, number of UTIs, cost of urinalysis, urine culture, urine cytology, and days of sick leave. The mean age was 57.71 years but was found to be lower in GV. The mean expenditure on UTI prophylaxis and treatment per patient was EUR 4908.07, but this found to be higher in GO. Emergency primary care visits were more frequent in GA. The ordinary scheduled visits to primary care visits were more frequent in GV and GO. The mean successive visits was 2.47 and was shown to be lower in GV. The mean expenditure on successive visits was EUR 341.64 but was found to be lower in GV. The mean number of UTIs was 4.83 at 3 months after finishing prophylaxis and 5.01 at 12 months, and it was observed to be lower in GV. Less frequent VCU usage, older age, more ASA III, more frequent use of urinalyses, urine cultures, ultrasounds, and CT scans were associated with higher costs. In GO, IVU was associated with higher costs. The total expenditure related to RUTIs is associated with older age and the number of RUTIs, a poorer general health status, and the use of urinary tract ultrasounds and CT scans. The use of VCUs instead of ultrasounds and CT scans is cost-effective in the management of RUTIs in older women. Immunoprophylaxis is more cost-effective in reducing the number of visits to the primary care emergency room, the number of successive visits to the Urology Department, the number of intercurrent infections, and the need for urinalyses, urine cultures, CT scans, and ultrasounds in the primary care emergency room.

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