Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Feb 19;14(2):211.
doi: 10.3390/antibiotics14020211.

A Precision Medicine Model for Targeted Antibiotic Therapy in Urinary Tract Infections: A Valuable Tool to Reduce Hospitalization Stay and the Time to Switch to Oral Treatment

Tommaso Cai  1   2 , Anna Brugnolli  3   4 , Massimiliano Lanzafame  4   5 , Fabiana Dellai  6 , Carlo Tascini  6 , Claudio Scarparo  7 , Vito Racanelli  4   8 , Orietta Massidda  4   9 , Gernot Bonkat  10 , Luca Gallelli  11 , Truls E Bjerklund Johansen  2   12   13
Affiliations

A Precision Medicine Model for Targeted Antibiotic Therapy in Urinary Tract Infections: A Valuable Tool to Reduce Hospitalization Stay and the Time to Switch to Oral Treatment

Tommaso Cai et al. Antibiotics (Basel). .

Abstract

Background/Objectives: The management of urinary tract infections (UTIs) has become an increasingly challenging medical intervention. This study explores whether adoption of a precision medicine model could improve the management of acute uncomplicated pyelonephritis (uAPN) or complicated UTIs (cUTIs) compared with the standard of care approach, in hospitalized patients. Methods: From January 2022 to March 2024, all patients affected by uAPN or cUTIs and attending our urological institution were randomized to receive the following: antibiotic treatment according to guidelines and recommendations (standard of care group) or antibiotic treatment according to the precision medical model (intervention group). The main outcome measures were the rates of clinical success and the length of hospitalization. The time until switching to oral treatment was regarded as a secondary outcome measure. Results: Eighty-three patients were enrolled in the standard of care group, while seventy-nine patients were enrolled in the intervention group. While the overall clinical success rate was similar in the two groups (75 vs. 72; p = 0.97), a statistically significant difference was observed between the two groups in terms of length of hospitalization (8 days vs. 5 days; p = 0.03) and time to switch to oral treatment (96 h vs. 72 h; p = 0.04). A statistically significant difference was found between the two groups regarding the need to change antimicrobial therapy during hospitalization [12 out of 80 vs. 6 out of 77; p = 0.04]. Conclusions: Adoption of the precision medicine model appears as a valuable means to improve the management of patients with uAPN and cUTIs. By reducing the period of hospitalization and the time to switch to oral treatment, the precision medicine model also improves antimicrobial stewardship in the management of UTIs.

Keywords: antibiotic resistance; antibiotic stewardship; precision medicine; risk factors; urinary tract infection.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The figure shows the study schedule.
Figure 2
Figure 2
The figure shows the precision-medicine-based therapy of uAPN or cUTI.
See this image and copyright information in PMC

References

    1. Nguyen H.Q., Nguyen N.T.Q., Hughes C.M., O’Neill C. Trends and impact of antimicrobial resistance on older inpatients with urinary tract infections (UTIs): A national retrospective observational study. PLoS ONE. 2019;14:e0223409. doi: 10.1371/journal.pone.0223409. - DOI - PMC - PubMed
    1. EAU European Association of Urology Guidelines on Urological Infections, Update 2023. [(accessed on 26 July 2024)]. Available online: http://uroweb.org/guideline/urological-infections/
    1. Kranz J., Bartoletti R., Bruyère F., Cai T., Geerlings S., Köves B., Schubert S., Pilatz A., Veeratterapillay R., Wagenlehner F.M.E., et al. European Association of Urology Guidelines on Urological Infections: Summary of the 2024 Guidelines. Eur. Urol. 2024;86:27–41. doi: 10.1016/j.eururo.2024.03.035. - DOI - PubMed
    1. Aldea M., Friboulet L., Apcher S., Jaulin F., Mosele F., Sourisseau T., Soria J.C., Nikolaev S., André F. Precision medicine in the era of multi-omics: Can the data tsunami guide rational treatment decision? ESMO Open. 2023;8:101642. doi: 10.1016/j.esmoop.2023.101642. - DOI - PMC - PubMed
    1. Isali I., Wong T.R., Batur A.F., Wu C.W., Schumacher F.R., Pope R., Hijaz A., Sheyn D. Recurrent urinary tract infection genetic risk: A systematic review and gene network analysis. Int. Urogynecol. J. 2023;35:259–271. doi: 10.1007/s00192-023-05671-6. - DOI - PubMed

LinkOut - more resources