Effect of microbiology comment nudging on antibiotic use in asymptomatic bacteriuria: A before-and-after quasi-experimental study.

Autor: Belk MG; Huntsville Hospital, Department of Pharmacy, Huntsville, Alabama., Hammond OD; TriStar Centennial Medical Center, Nashville, Tennessee., Seales CC; Texas Tech University Health Sciences Center, Lubbock, Texas., Edwards JD; Huntsville Hospital, Department of Pharmacy, Huntsville, Alabama., Steuber TD; Huntsville Hospital, Department of Pharmacy, Huntsville, Alabama.; Auburn University Harrison School of Pharmacy, Pharmacy Practice, Huntsville, Alabama.
Jazyk: angličtina
Zdroj: Infection control and hospital epidemiology [Infect Control Hosp Epidemiol] 2023 Sep; Vol. 44 (9), pp. 1391-1395. Date of Electronic Publication: 2023 Mar 16.
DOI: 10.1017/ice.2022.272
Abstrakt: Objective: To describe the effect of a microbiology comment nudge on antibiotic use for asymptomatic bacteriuria (ASB).
Design: Single-center, before-and-after, quasi-experimental study.
Setting: Community-based, public, not-for-profit teaching hospital in the southeastern United States.
Participants: Adult inpatients with a positive urine culture and the absence of urinary tract infection signs and symptoms.
Intervention: Implementation of a microbiology comment nudge on urine cultures.
Results: In total, 204 patients were included in the study. Antibiotics were less likely to be continued beyond 72 hours in the postimplementation group: 57 (55%) of 104 versus 38 (38%) of 100 ( P = .016). They were less likely to have antibiotics continued beyond 48 hours: 60 (58%) of 104 versus 43 (43%) of 100 ( P = .036). They were also less likely to have antibiotics prescribed at discharge 35 (34%) of 104 versus 20 (20%) of 100 ( P = .028). In addition, they had fewer total antibiotic days of therapy: 4 (IQR, 1-6) versus 1 (IQR, 0-6) ( P = .022).
Conclusion: Microbiology comment nudging may contribute to less antibiotic utilization in patients with ASB.
Databáze: MEDLINE