Treatment of urinary tract infections: Selecting an appropriate broad-spectrum antibiotic for nosocomial infections

1996 ◽  
Vol 100 (6) ◽  
pp. 76S-82S ◽  
Author(s):  
Roohollah Sharifi ◽  
Ronald Gecklera ◽  
Stacy Childs
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Broad Spectrum ◽  
Nosocomial Infections ◽  
Broad Spectrum Antibiotic ◽  
Tract Infections

scholarly journals Catheter-associated urinary tract infections in Clinical Center of Banja Luka

2003 ◽  
Vol 56 (9-10) ◽  
pp. 460-464 ◽  
Author(s):  
Antonija Verhaz ◽  
Ranko Skrbic ◽  
Mirjana Rakic-Music ◽  
Ana Sabo
Keyword(s):  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Nursing Staff ◽  
Nosocomial Infections ◽  
Clinical Performance ◽  
Urinary Catheters ◽  
Clinical Center ◽  
Banja Luka ◽  
Tract Infections

Introduction Catheter-associated urinary tract infections are the most common nosocomial infections of the urinary tract, and among the most common nosocomial infections in general. The major problems of these infections include antibiotic resistance and enormous direct and indirect cost of treatment. Material and methods A retrospective study on major causes of infections and antibiotic resistance was conducted at four clinics of the Clinical Center of Banja Luka. An anonymous questionnaire was distributed to nursing staff dealing with urinary catheters in order to get an overview of their clinical performance. Results The results showed that in 89% of cases (out of 198 patients with developed catheter-associated urinary tract infection) infections were caused by gram-negative bacteria, in 7% by gram-positive bacteria and in 4% by Candida. The most common bacteria were: Escherichia coli (33.6%), Pseudomonas aeruginosa (14.1%), Proteus mirabilis (13.3%), and Enterobacter (10.5%). Majority of bacteria presented with extremely high resistance (72-100%) to ampicillin, gentamycin and cotrimoxazole, and in some cases a significant resistance to ciprofloxacine, nalidixic acid, ceftriaxone and ceftazidime. The questionnaire showed that nursing staff did not follow guidelines for medical care of patients with urinary catheters. Conclusion It can be concluded that poor hygienic and epidemiological conditions, as well as irrational use of antibiotics contribute to uncontrolled development of urinary tract infections in catheterized patients.

scholarly journals Impact of selective reporting of antibiotic susceptibility test results in urinary tract infections in the outpatient setting: a protocol for a pragmatic, prospective quasi-experimental trial

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e025810 ◽  
Author(s):  
Francesca Binda ◽  
Sébastien Fougnot ◽  
Patrice De Monchy ◽  
Anne Fagot-Campagna ◽  
Céline Pulcini ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Broad Spectrum ◽  
Antibiotic Susceptibility ◽  
Outpatient Setting ◽  
Susceptibility Test ◽  
Selective Reporting ◽  
Broad Spectrum Antibiotics ◽  
Antibiotic Susceptibility Test ◽  
Tract Infections

IntroductionAntibiotic resistance is a serious and increasing worldwide threat to global public health. One of antibiotic stewardship programmes’ objectives are to reduce inappropriate broad-spectrum antibiotics’ prescription. Selective reporting of antibiotic susceptibility test (AST) results, which consists of reporting to prescribers only few (n=5-6) antibiotics, preferring first-line and narrow-spectrum agents, is one possible strategy advised in recommendations. However, selective reporting of AST has never been evaluated using an experimental design.Methods and analysisThis study is a pragmatic, prospective, multicentre, controlled (selective reporting vs usual complete reporting of AST), before-after (year 2019 vs 2017) study. Selective reporting of AST is scheduled to be implemented from September 2018 in the ATOUTBIO group of 21 laboratories for all Escherichia coli identified in urine cultures in adult outpatients, and to be compared with the usual complete AST performed in the EVOLAB group of 20 laboratories. The main objective is to assess the impact of selective reporting of AST for E. coli-positive urine cultures in the outpatient setting on the prescription of broad-spectrum antibiotics frequently used for urinary tract infections (amoxicillin-clavulanate, third-generation cephalosporins and fluoroquinolones). The primary end point is the after (2019)–before (2017) difference in prescription rates for the previously mentioned antibiotics/classes that will be compared between the two laboratory groups, using linear regression models. Secondary objectives are to evaluate the feasibility of selective reporting of AST implementation by French laboratories and their acceptability by organising focus groups and individual semi-structured interviews with general practitioners and laboratory professionals.Ethics and disseminationThis protocol was approved by French national ethics committees (Comité d’expertise pour les recherches, les études et les évaluations dans le domaine de la santé (TPS 29064) and Commission Nationale de l’Informatique et des Libertés (Décision DR-2018–141)). Findings of this study will be widely disseminated through conference presentations, reports, factsheets and academic publications and generalisation will be further discussed.Trial registration numberNTC03612297.

scholarly journals Two Simple Rules for Improving the Accuracy of Empiric Treatment of Multidrug-Resistant Urinary Tract Infections

2015 ◽  
Vol 59 (12) ◽  
pp. 7593-7596 ◽  
Author(s):  
Katherine Linsenmeyer ◽  
Judith Strymish ◽  
Kalpana Gupta
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Broad Spectrum ◽  
Empiric Therapy ◽  
Multidrug Resistant ◽  
Veterans Affairs ◽  
Department Of Veterans Affairs ◽  
Simple Rules ◽  
Tract Infections ◽  
Outpatient Settings

ABSTRACTThe emergence of multidrug-resistant (MDR) uropathogens is making the treatment of urinary tract infections (UTIs) more challenging. We sought to evaluate the accuracy of empiric therapy for MDR UTIs and the utility of prior culture data in improving the accuracy of the therapy chosen. The electronic health records from three U.S. Department of Veterans Affairs facilities were retrospectively reviewed for the treatments used for MDR UTIs over 4 years. An MDR UTI was defined as an infection caused by a uropathogen resistant to three or more classes of drugs and identified by a clinician to require therapy. Previous data on culture results, antimicrobial use, and outcomes were captured from records from inpatient and outpatient settings. Among 126 patient episodes of MDR UTIs, the choices of empiric therapy against the index pathogen were accurate in 66 (52%) episodes. For the 95 patient episodes for which prior microbiologic data were available, when empiric therapy was concordant with the prior microbiologic data, the rate of accuracy of the treatment against the uropathogen improved from 32% to 76% (odds ratio, 6.9; 95% confidence interval, 2.7 to 17.1;P< 0.001). Genitourinary tract (GU)-directed agents (nitrofurantoin or sulfa agents) were equally as likely as broad-spectrum agents to be accurate (P= 0.3). Choosing an agent concordant with previous microbiologic data significantly increased the chance of accuracy of therapy for MDR UTIs, even if the previous uropathogen was a different species. Also, GU-directed or broad-spectrum therapy choices were equally likely to be accurate. The accuracy of empiric therapy could be improved by the use of these simple rules.

Multicenter Study of the Prevalence of Nosocomial Infections in Italian Hospitals

2004 ◽  
Vol 25 (1) ◽  
pp. 85-87 ◽  
Author(s):  
Carlo Di Pietrantonj ◽  
Lorenza Ferrara ◽  
G. Lomolino
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Multicenter Study ◽  
Nosocomial Infections ◽  
Point Prevalence ◽  
Prevalence Study ◽  
Infection Rates ◽  
Point Prevalence Study ◽  
Tract Infections

AbstractA point-prevalence study of nosocomial infections was conducted in 10 generai hospitals in northwestern Italy in June and July 2000. Infection rates were compared by type and site among the different hospitals. Urinary tract infections were most frequent, accounting for 57.8% of 128 nosocomial infections.

Biologically active antimicrobial compounds from marine microorganisms (2005-2019)

2020 ◽  
Vol 21 ◽  
Author(s):  
K Muddukrishnaiah ◽  
K Akilandeswari ◽  
Sunnapu Prasad ◽  
V P Shilpa
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Nosocomial Infections ◽  
Well Being ◽  
Biologically Active ◽  
Antimicrobial Compounds ◽  
Marine Microorganism ◽  
Marine Microorganisms ◽  
Marine Habitats ◽  
Tract Infections

Introduction: The increase in contagious diseases like nosocomial infections, urinary tract infections, and meningitis has led to the emergence of antimicrobial resistance urgently needs new antimicrobial medication with new modes of action. Some of the antibiotics present in the market have been obtained from terrestrial plants, or extracted semisynthetically from materials which can be fermented. Methods: Marine microorganisms account for approximately 80% of sea biomass and they are essential for the survival and well-being of aquatic habitats owing to their indispensable contribution to biogeochemical cycles and biological processes. In marine ecosystems, microorganisms live as microbial communities in seawater, where symbiotic relationships are formed, and their ecological functions are fulfilled. Results: Marine microorganisms remain the largest, most diverse and most exciting source of structurally and functionally complex antimicrobial agents. They are extremely involved in their structure and functions. Enormous biological wealth lies in marine habitats. These microorganisms are potential sources of novel antimicrobial compounds to combat the most infectious diseases like nosocomial infections, urinary tract infections. Conclusion: This study deals with biologically active antimicrobial compounds taken from marine microorganism source which was reported between the years 2005 and 2019. This review highlights their chemical groups, their bioactivities and sources. Marine microorganism exploitation techniques have also been reported by the authors.

scholarly journals 1115. Reducing Broad-Spectrum Antibiotics for Uncomplicated Urinary Tract Infections: A Multimodal Stewardship Intervention

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S396-S397
Author(s):  
Maryrose R Laguio-Vila ◽  
Mary L Staicu ◽  
Mary Lourdes Brundige ◽  
Jose Alcantara-Contreras ◽  
Hongmei Yang ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Phase I ◽  
Urinary Tract Infections ◽  
Broad Spectrum ◽  
Phase 1 ◽  
Phase 2 ◽  
Intervention Phase ◽  
Broad Spectrum Antibiotics ◽  
Stewardship Program ◽  
Tract Infections

Abstract Background Urinary tract infections (UTIs) are the second most common reason for antibiotics in hospitalized patients, with most receiving broad-spectrum antibiotics (BSA) regardless of infection severity. The antimicrobial stewardship program (ASP) conducted a multimodal stewardship intervention targeting reduction in one BSA, ceftriaxone, and promoted narrow-spectrum antibiotics (NSA) such as cefazolin and cephalexin for uncomplicated UTIs. Methods Phase 1: In February 2018, the ASP created a pocket card (Figure 1) containing (1) a urinary antibiogram outlining the most common urine pathogens and their local susceptibility to NSA and (2) NSA guidelines for UTIs with 0–1 systemic inflammatory response syndrome (SIRS) criteria. ASP performed a daily prospective audit with feedback on all new orders of ceftriaxone and promoted prescription of NSA. Phase 2: In August 2018, a Best Practice Alert (BPA) in the electronic medical record (EMR) was designed to interrupt providers ordering ceftriaxone with the indication of a UTI, and prompted NSA prescription instead. Quarterly didactic sessions on UTI antibiotic use and BPA functionality were done. We compared antibiotics usage rates across the 3 study phases (pre-intervention, phase I and phase II) by computing rate ratios (RRs) using Poisson regression. Results Compared with pre-intervention, phase 1 resulted in a significant decrease in ceftriaxone DOT (RR: 1.06, CI: 1.03–1.09, P < 0.001) and ceftriaxone orders for UTI (RR: 1.14, P < 0.001) and an increase in cefazolin DOT (RR: 0.89, P = 0.029) and orders for UTI (RR; 0.12, P < 0.001). It also resulted in a significant increase in cephalexin DOT (RR: 0.92, P = 0.002) and orders for UTI (RR: 0.58, P < 0.001). In phase 2, an additional significant reduction in ceftriaxone DOT (RR: 1.04, CI: 1.01–1.08, P = 0.018) and orders for UTI (RR: 1.62, P < 0.001) and an increase in cefazolin DOT (RR: 0.96, P < 0.001) and orders for UTI (RR; 0.56, P < 0.001) occurred, when comparing phase I to phase 2. It also resulted in a decrease in cephalexin DOT (RR: 0.83, P < 0.001) and orders for UTI (RR: 0.70, P < 0.001). Conclusion A multimodal stewardship intervention using a pocket card with guidelines and urine antibiogram, and an EMR BPA successfully reduced BSA and increased NSA for treatment of uncomplicated UTIs. Disclosures All authors: No reported disclosures.

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