P-1550. Systematic Literature Review of Acute Cystitis or Afebrile Urinary Tract Infection in Men
Authors: Mitrani-Gold Fanny S , Martin Amber , Wittkopf Priscilla , Kamar Joanna , Preib Madison T , Joshi Ashish V , Mulgirigama Aruni 
Published: January 2025

Abstract

Background
Acute cystitis in men is classified as complicated urinary tract infection (UTI), despite the absence of functional and/or structural anatomical abnormalities of the urinary tract, associated with a higher risk of treatment failure. We conducted a systematic literature review (SLR) to identify and summarize evidence on the epidemiology (incidence, etiology, antimicrobial resistance [AMR], recurrence) and treatment patterns of acute cystitis or afebrile UTI among men with no signs of systemic infection.

Methods
Systematic searches for English language articles were conducted Jan 1, 2011–May 12, 2023 in the MEDLINE, MEDLINE In-Process, and Embase databases via OvidSP. Gray literature sources (Table 1) were reviewed. Publications were evaluated by 2 independent reviewers (Table 2).

Results
Database searches yielded 1025 records with 6 studies eligible for inclusion (Figure 1). Studies were primarily excluded if the population of interest was not included or if outcomes were inseparable for the population of interest. The 6 studies were conducted 2012–2020 in 6 geographic regions (1 US). Sample sizes ranged from 18 to 4876 patients. Four studies reported age (median 44–71 years; Table 3). Population of interest was defined as “uncomplicated” (3 studies) or “acute cystitis”/“afebrile UTI” (3 studies). The incidence of uncomplicated UTI was 6.5/1000 person-years in a retrospective cohort (Netherlands) and increased with age. Relapse, defined as continuation of UTI symptoms ≤ 28 days of stopping treatment, after initial symptom resolution, ranged from 9.9% to 16.9% (referred to as recurrence rates in this study). Escherichia coli (E. coli) were the etiologic bacteria in 39–94% of patients. Nitrofurantoin (56.0%) and fluoroquinolones (62.8%) were the most commonly prescribed antibiotics in the Netherlands and Japan, respectively. AMR among E. coli ranged from 11.8% to 47.1% in 1 study.

Conclusion
AMR in males with acute cystitis/afebrile UTI may be higher than females in some geographic regions. The SLR identified 6 studies with heterogenous designs, inclusion criteria, and UTI definitions, highlighting the need for research using standard definitions to characterize acute cystitis/afebrile UTI in men, including recurrence rates and the burden of AMR.
Funding: GSK study 220916

Disclosures
Fanny S. Mitrani-Gold, MPH, GSK: Employee|GSK: Stocks/Bonds (Public Company) Amber Martin, BS, PPD Evidera: Employee of PPD Evidera, which received funding from GSK for this study. Priscilla Wittkopf, PhD, GSK: Grant/Research Support|PPD Evidera: Employee of PPD Evidera, which received funding from GSK for this study.|ThermoFisher Scientific: Stocks/Bonds (Private Company) Joanna Kamar, MPH, PPD Evidera: Employee of PPD Evidera, which received funding from GSK for this study. Madison T. Preib, MPH, GSK: Employee|GSK: Stocks/Bonds (Public Company) Ashish V. Joshi, PhD, GSK: Employee|GSK: Stocks/Bonds (Public Company) Aruni Mulgirigama, MBBS, GSK: Employee|GSK: Stocks/Bonds (Public Company)