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 Scientists discover the basics of how pressure-sensing Piezo proteins work
22.08.2019 | Weill Cornell Medicine

nachricht Protein-transport discovery may help define new strategies for treating eye disease
22.08.2019 | Scripps Research Institute

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: Hamburg and Kiel researchers observe spontaneous occurrence of skyrmions in atomically thin cobalt films

Since their experimental discovery, magnetic skyrmions - tiny magnetic knots - have moved into the focus of research. Scientists from Hamburg and Kiel have now been able to show that individual magnetic skyrmions with a diameter of only a few nanometres can be stabilised in magnetic metal films even without an external magnetic field. They report on their discovery in the journal Nature Communications.

The existence of magnetic skyrmions as particle-like objects was predicted 30 years ago by theoretical physicists, but could only be proven experimentally in...

Im Focus: Physicists create world's smallest engine

Theoretical physicists at Trinity College Dublin are among an international collaboration that has built the world's smallest engine - which, as a single calcium ion, is approximately ten billion times smaller than a car engine.

Work performed by Professor John Goold's QuSys group in Trinity's School of Physics describes the science behind this tiny motor.

Im Focus: Quantum computers to become portable

Together with the University of Innsbruck, the ETH Zurich and Interactive Fully Electrical Vehicles SRL, Infineon Austria is researching specific questions on the commercial use of quantum computers. With new innovations in design and manufacturing, the partners from universities and industry want to develop affordable components for quantum computers.

Ion traps have proven to be a very successful technology for the control and manipulation of quantum particles. Today, they form the heart of the first...

Im Focus: Towards an 'orrery' for quantum gauge theory

Experimental progress towards engineering quantized gauge fields coupled to ultracold matter promises a versatile platform to tackle problems ranging from condensed-matter to high-energy physics

The interaction between fields and matter is a recurring theme throughout physics. Classical cases such as the trajectories of one celestial body moving in the...

Im Focus: A miniature stretchable pump for the next generation of soft robots

Soft robots have a distinct advantage over their rigid forebears: they can adapt to complex environments, handle fragile objects and interact safely with humans. Made from silicone, rubber or other stretchable polymers, they are ideal for use in rehabilitation exoskeletons and robotic clothing. Soft bio-inspired robots could one day be deployed to explore remote or dangerous environments.

Most soft robots are actuated by rigid, noisy pumps that push fluids into the machines' moving parts. Because they are connected to these bulky pumps by tubes,...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

The power of thought – the key to success: CYBATHLON BCI Series 2019

16.08.2019 | Event News

4th Hybrid Materials and Structures 2020 28 - 29 April 2020, Karlsruhe, Germany

14.08.2019 | Event News

What will the digital city of the future look like? City Science Summit on 1st and 2nd October 2019 in Hamburg

12.08.2019 | Event News

 
Latest News

Making small intestine endoscopy faster with a pill-sized high-tech camera

23.08.2019 | Medical Engineering

More reliable operation offshore wind farms

23.08.2019 | Power and Electrical Engineering

Tracing the evolution of vision

23.08.2019 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>