title: Antecedent antimicrobial use increases the risk of uncomplicated cystitis in young women.
abstract: To examine whether antecedent antimicrobial use influenced subsequent relative risk of urinary tract infection (UTI) in premenopausal women, data were analyzed from two cohorts of women observed prospectively for 6 months to determine risk factors for UTI. Using a Cox proportional hazards model to adjust for covariates, we found that 326 women in a University cohort and 425 women in a health-maintenance organization cohort were at increased risks for UTI (2.57 [95% confidence interval (CI), 1.24-5.32] and 5.83 [95% CI, 3.17-10.70], respectively) if antimicrobials had been taken during the previous 15-28 days but not during the previous 3, 7, or 14 days. The increased risks were noted both for women whose antimicrobial use was for treatment of a previous UTI and for women who received antimicrobials for other illnesses. These results suggest that recent antimicrobial use increases a woman's risk of UTI, perhaps by altering the indigenous urogenital flora and predisposing to vaginal colonization with uropathogens.
authors.affiliation: Department of Epidemiology, University of Washington School of Medicine, Seattle, USA.
authors.forename: H S
authors.initials: HS
authors.lastname: Smith
authors.forename: J P
authors.initials: JP
authors.lastname: Hughes
authors.forename: T M
authors.initials: TM
authors.lastname: Hooton
authors.forename: P
authors.initials: P
authors.lastname: Roberts
authors.forename: D
authors.initials: D
authors.lastname: Scholes
authors.forename: A
authors.initials: A
authors.lastname: Stergachis
authors.forename: A
authors.initials: A
authors.lastname: Stapleton
authors.forename: W E
authors.initials: WE
authors.lastname: Stamm
mesh_terms: D000293:Adolescent; D000328:Adult; D000890:Anti-Infective Agents / Q000009:adverse effects*; D015331:Cohort Studies; D003556:Cystitis / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors
chemical_list: D000890:Anti-Infective Agents