Outpatient antimicrobial stewardship: Targets for urinary tract infections
| Autor: | Bethany A. Wattengel, Kari A. Mergenhagen, Sara DiTursi, John A. Sellick, Jennifer Schroeck |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Epidemiology medicine.drug_class Urinary system Antibiotics Bacteriuria Antimicrobial Stewardship 03 medical and health sciences 0302 clinical medicine Internal medicine Chart review Outpatients medicine Humans Antimicrobial stewardship 030212 general & internal medicine Practice Patterns Physicians' Retrospective Studies 0303 health sciences 030306 microbiology business.industry Health Policy Public Health Environmental and Occupational Health Drug Utilization Review medicine.disease Pyuria Anti-Bacterial Agents Catheter Infectious Diseases Urinary Tract Infections medicine.symptom business |
| Zdroj: | American Journal of Infection Control. 48:1009-1012 |
| ISSN: | 0196-6553 |
| DOI: | 10.1016/j.ajic.2019.12.018 |
| Popis: | Urinary tract infections (UTIs) are common. Outpatient antimicrobial stewardship programs are emerging and a focused approach to UTIs is needed to help guide programs.Data were collected by retrospective chart review of outpatients using encounters from January 2005 to March 2018. Antibiotic therapy was indicated if at least one UTI symptom was present. Antibiotic therapy was appropriate if consistent with guidelines and culture results. Factors that differed significantly (P .05) between the comparator groups were built into a multivariable logistic regression model to determine factors associated with inappropriate prescribing.A total of 607 outpatients were included, of which approximately 68% were treated inappropriately. Inappropriate regimens consisted of 50.9% (n = 309) incorrect durations, 35.1% (n = 213) incorrect choice of antibiotic, and 12.4% (n = 75) incorrect doses. Ten percent of patients developed a reinfection within 30 days. Recurrence of UTI with the same pathogen within 30 days occurred in 5.1%. Catheter use and advanced age are both risk factors for recurrence and inappropriate treatment.Outpatient antibiotic prescribing for UTIs is suboptimal. Stewardship programs should focus on patients with catheters and of advanced age as they are often inappropriately treated. |
| Databáze: | OpenAIRE |
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