ARGUS study - clinical and bacteriological outcomes dataset

Background: Treatment for urinary tract infections (UTIs) is usually
empiric and is based on local antimicrobial resistance data. These data,
however, are scarce in low-resource settings. The aim of this study is to
determine the impact of antibiotic treatment on clinical and
bacteriological outcomes in patients presenting with UTI symptoms to
primary care in Harare. Methods: This cohort study enrolled participants
presenting with UTI symptoms to 10 primary healthcare clinics in Harare
between July 2019 and July 2020. A questionnaire was administered and a
urine sample was collected for culture. If the urine culture showed growth
of ≥105 colony forming units/mL of a uropathogen, a follow up visit at
7-21 days was conducted. Results: The analysis included 168 participants
with a median age of 33.6 years (IQR 25.1-51.4) and of whom 131/168
(78.0%) were female. Effective treatment was taken by 54/168 (32.1%)
participants. The urine culture was negative at follow up in 41/54 (75.9%)
of participants who took appropriate treatment and in 33/114 (28.9%,
p<0.001) of those who did not. Symptoms had improved or resolved in
52/54 (96.3%) of those on appropriate treatment and in 71/114 (62.3%,
p<0.001) of those without. Conclusion: The findings of this study
show that effective treatment leads to symptom resolution and bacterial
clearance in people presenting with UTIs to primary care. Although UTIs
are not life-threatening and can resolve without treatment, they do impact
on quality of life, highlighting the need for optimised treatment
recommendations.