Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Simple lab-based change may help reduce unnecessary antibiotic therapy, improve care

27.02.2014

Modifying how urine culture results are reported to clinicians can improve prescribing practices, pilot study suggests

 A simple change in how the hospital laboratory reports test results may help improve antibiotic prescribing practices and patient safety, according to a pilot, proof-of-concept study published in Clinical Infectious Diseases and now available online. No longer routinely reporting positive urine culture results for inpatients at low risk for urinary tract infections (UTIs) greatly reduced unnecessary antibiotic prescriptions and did not affect the treatment of patients who did need antibiotics, the study authors found.

Urine cultures for hospitalized patients are often ordered unnecessarily. Positive culture results from patients without any UTI symptoms can lead to antibiotic prescriptions that are of no benefit and may cause harm to patients, including C. difficile infection and subsequent infection with more antibiotic-resistant bacteria.

In the study, conducted in 2013 at Mount Sinai Hospital in Toronto, urine culture results from non-catheterized inpatients—those at lower risk for developing a UTI—were no longer reported automatically to the ordering physician. Instead, a message was posted to the patient's electronic medical record asking caregivers to call the lab for the results only if a UTI was strongly suspected.

The message reminded providers that "the majority of positive urine cultures from inpatients without an indwelling urinary catheter represent asymptomatic bacteriuria," a condition for which current practice guidelines do not usually recommend antibiotics, unless the patient is pregnant or will be undergoing certain urological procedures.

After the change in how the culture results were reported, the rate of antibiotic treatment for asymptomatic bacteriuria among non-catheterized patients decreased from 48 percent to 12 percent. Treatment rates among patients in the catheterized control group—whose culture results were routinely reported as before—remained steady, at 41 percent. Patients with positive culture results were assessed by a study investigator for UTI symptoms within 24 hours. Four UTIs developed among the non-catheterized patients; in all of these cases, clinicians had already started appropriate antibiotic treatment when the urine cultures were ordered, based on the patients' symptoms.

"In clinical medicine, there are many examples of tests that are not routinely processed or reported when they have been shown to be of very low yield or associated with potential harms, and special requests are required in these cases," said lead study author Jerome A. Leis, MD, MSc, of Sunnybrook Health Sciences Centre in Toronto. "We believe this to be true of some urine cultures from medical and surgical floors where we know that the majority of positive results occur in patients without symptoms of urinary tract infection and lead to unnecessary and potentially harmful therapy with antibiotics."

The study authors stressed the need for larger studies to confirm the overall generalizability, safety, and sustainability of such a change in urine culture reporting before it is implemented more broadly and in other practice settings.

Fast Facts:

1) Positive urine culture results for hospitalized patients at low risk for developing a urinary tract infection (UTI) can lead clinicians to prescribe unnecessary and sometimes harmful antibiotic therapy. Most positive urine cultures from inpatients who do not have a urinary catheter represent asymptomatic infections that do not require antibiotics.

2) In a pilot, proof-of-concept study, no longer routinely reporting positive urine culture results for inpatients at low risk for UTIs greatly reduced unnecessary antibiotic prescriptions and did not affect the treatment of patients who did need antibiotics.

3) Larger studies are needed to confirm the generalizability, safety, and sustainability of such an approach before it is implemented more broadly and in other practice settings.

Jerica Pitts | EurekAlert!
Further information:
http://www.pcipr.com

Further reports about: Infectious UTI antibiotic antibiotics catheter symptoms therapy urine

More articles from Health and Medicine:

nachricht UV light robot to clean hospital rooms could help stop spread of 'superbugs'
15.04.2015 | Texas A&M University

nachricht Heart cells regenerated in mice
14.04.2015 | Weizmann Institute of Science

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Astronomers reveal supermassive black hole's intense magnetic field

Astronomers from Chalmers University of Technology have used the giant telescope Alma to reveal an extremely powerful magnetic field very close to a supermassive black hole in a distant galaxy

Astronomers from Chalmers University of Technology have used the giant telescope Alma to reveal an extremely powerful magnetic field very close to a...

Im Focus: A “pin ball machine” for atoms and photons

A team of physicists from MPQ, Caltech, and ICFO proposes the combination of nano-photonics with ultracold atoms for simulating quantum many-body systems and creating new states of matter.

Ultracold atoms in the so-called optical lattices, that are generated by crosswise superposition of laser beams, have been proven to be one of the most...

Im Focus: UV light robot to clean hospital rooms could help stop spread of 'superbugs'

Can a robot clean a hospital room just as well as a person?

According to new research out of the Texas A&M Health Science Center College of Medicine, that is indeed the case. Chetan Jinadatha, M.D., M.P.H., assistant...

Im Focus: Graphene pushes the speed limit of light-to-electricity conversion

Researchers from ICFO, MIT and UC Riverside have been able to develop a graphene-based photodetector capable of converting absorbed light into an electrical voltage at ultrafast timescales

The efficient conversion of light into electricity plays a crucial role in many technologies, ranging from cameras to solar cells.

Im Focus: Study shows novel pattern of electrical charge movement through DNA

Electrical charges not only move through wires, they also travel along lengths of DNA, the molecule of life. The property is known as charge transport.

In a new study appearing in the journal Nature Chemistry, authors, Limin Xiang, Julio Palma, Christopher Bruot and others at Arizona State University's...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

HHL's Entrepreneurship Conference on FinTech

13.04.2015 | Event News

World Conference On Regenerative Medicine 2015: Registration And Abstract Submission Now Open

25.03.2015 | Event News

University presidents from all over the world meet in Hamburg

19.03.2015 | Event News

 
Latest News

Engineer Improves Rechargeable Batteries with MoS2 Nano 'Sandwich'

17.04.2015 | Power and Electrical Engineering

Comparing Climate Models to Real World Shows Differences in Precipitation Intensity

17.04.2015 | Earth Sciences

A blueprint for clearing the skies of space debris

17.04.2015 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>