Identifying Optimal Antibiotic Regimens to Treat Urinary Tract Infections During Pregnancy

确定治疗妊娠期尿路感染的最佳抗生素方案

基本信息

批准号：
10838231
负责人：
Anne Mobley Butler
金额：
$ 5.88万
依托单位：
WASHINGTON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-08-01 至 2025-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10838231
关键词：
Alaska Native Ambulatory Care American College of Obstetricians and Gynecologists American Indians Antibiotics Antimicrobial Resistance Antimicrobial susceptibility Award Bacteriuria Biometry Black race Caring Child Clinical Communicable Diseases Congenital Abnormality Data Development Diagnosis Disparity Disparity in diagnosis Effectiveness Electronic Health Record Epidemiology Ethnic Origin Ethnic Population Exclusion Failure First Pregnancy Trimester Foundations Goals Grant Guidelines Health Health Disparities Research Health Services Accessibility Healthcare Systems Hispanic Improve Access Incidence Infant Infant Health Infant Mortality Infection Integrated Health Care Systems Intervention Knowledge Low Birth Weight Infant Master of Science Maternal Health Mentors Native Hawaiian Not Hispanic or Latino Outcome Pacific Islander Parents Patients Pattern Persons Pharmacoepidemiology Population Population Heterogeneity Pregnancy Pregnancy loss Pregnant Women Premature Birth Premature Labor Prevalence Pyelonephritis Race Recommendation Regimen Research Research Personnel Research Support Risk Safety Sepsis Students Talents Treatment Failure Uncertainty Underrepresented Populations Universities Urinary tract infection Variant Washington Woman Women&apos s Health adverse outcome career career development comparative effectiveness comparative safety early pregnancy effective therapy ethnic difference ethnic disparity experience health disparity health equity improved ineffective therapies multidisciplinary perinatal complications pregnancy related death pregnant programs racial difference racial disparity racial minority population racial population randomized trial research and development routine screening screening guidelines skills standard of care symposium treatment duration treatment guidelines treatment risk tv watching underserved community

项目摘要

PROJECT SUMMARY Urinary tract infections (UTIs) are common in pregnancy and can have serious consequences including pregnancy loss and preterm birth. Minoritized racial and ethnic groups may have higher rates of UTI in pregnancy, but prior studies had important limitations. While some evidence suggests there are racial and ethnic disparities in diagnosis and treatment of other infections, little is known about potential disparities in UTI treatment in pregnancy. This Diversity Supplement would support Ms. Sandra McAteer, a talented master's student in Epidemiology at the University of Washington, to conduct relevant research and gain skills and experience needed for a successful career as a program manager leading interventions to improve the health of women and children. Ms. McAteer's primary mentor will be Dr. Sascha Dublin of Kaiser Permanente Washington, Co-Investigator on the Parent R01 grant. Dr. Anjum Hajat of the University of Washington will be co-mentor, bringing expertise in health disparities research. The Parent R01 aims to generate needed evidence about the comparative safety and effectiveness of antibiotics in pregnancy by analyzing administrative claims and electronic health records data. The Specific Aims of the Parent R01 are: 1) to characterize real-world prescribing patterns, concordance with existing guidelines, and antimicrobial susceptibility patterns relevant to the outpatient treatment of UTIs in pregnancy; 2) to compare the risk of treatment failure with commonly-used antibiotic regimens; and 2) to evaluate the comparative safety of these antibiotic regimens with respect to birth defects and perinatal complications. The Parent R01 does not include a health equity focus, and specifically, it does not examine whether there are differences in UTI incidence or treatment or in the prevalence of antimicrobial resistance by race or ethnicity. Specific Aims of the proposed Diversity Supplement Research are to characterize differences in the incidence and treatment of UTI in pregnancy by patient race and ethnicity, including differences in choice of antibiotic and concordance of treatment with clinical guidelines. For an exploratory aim, Ms. McAteer will examine differences in antimicrobial resistance by race and ethnicity. Ms. McAteer's Career Development and Research Plan will include coursework, directed readings, participation in seminars and conferences, and conducting research supported by a multidisciplinary group of mentors. These activities will help her build the scientific and professional skills for a successful career as a program manager leading interventions to improve the health of women and children from underrepresented groups. Impact: The proposed Diversity Supplement will augment the Parent R01 by adding a health equity focus and increasing knowledge about differences in incidence and treatment of UTIs by race and ethnicity. Results could be used to develop targeted interventions to improve care for UTIs in pregnancy and ultimately to improve health outcomes for pregnant people and infants.

项目概要尿路感染 (UTI) 在怀孕期间很常见，可能会造成严重后果，包括妊娠丢失和早产。少数种族和族裔群体的尿路感染发病率可能更高怀孕，但之前的研究有重要的局限性。虽然一些证据表明存在种族和其他感染的诊断和治疗方面存在种族差异，但人们对尿路感染的潜在差异知之甚少怀孕期间的治疗。该多样性补充品将支持桑德拉·麦卡蒂尔女士（Sandra McAteer），她是一位才华横溢的硕士华盛顿大学流行病学专业的学生，进行相关研究并获得技能和作为项目经理领导改善健康的干预措施，成功职业生涯所需的经验妇女和儿童。 McAteer 女士的主要导师将是 Kaiser Permanente 的 Sascha Dublin 博士华盛顿，Parent R01 资助项目的联合研究员。华盛顿大学的 Anjum Hajat 博士将共同导师，带来健康差异研究方面的专业知识。 Parent R01 旨在生成所需的通过分析获得有关妊娠期抗生素相对安全性和有效性的证据行政索赔和电子健康记录数据。母版 R01 的具体目标是： 1) 描述现实世界的处方模式、与现有指南的一致性以及抗菌药物与妊娠期尿路感染门诊治疗相关的易感性模式； 2）比较风险常用抗生素治疗失败； 2）评估这些药物的相对安全性针对出生缺陷和围产期并发症的抗生素治疗方案。父 R01 不包括健康公平焦点，具体而言，它不检查尿路感染发病率或治疗或按种族或族裔划分的抗菌药物耐药性流行情况。拟议的具体目标多样性补充研究旨在描述不同地区尿路感染的发病率和治疗差异不同种族和民族的妊娠情况，包括抗生素选择和药物一致性的差异按照临床指南进行治疗。为了实现探索性目标，麦卡蒂尔女士将研究抗菌剂的差异种族和民族的抵抗。麦卡蒂尔女士的职业发展和研究计划将包括课程作业、定向阅读、参加研讨会和会议以及开展研究支持由多学科导师组成的小组。这些活动将帮助她培养科学和专业技能作为一名项目经理，领导改善妇女健康的干预措施，取得成功的职业生涯来自代表性不足群体的儿童。影响：拟议的多样性补充将增强家长的能力 R01 通过增加对健康公平的关注并增加对疾病发病率和治疗差异的了解按种族和民族划分的尿路感染。结果可用于制定有针对性的干预措施，以改善对尿路感染的护理怀孕并最终改善孕妇和婴儿的健康结果。