scholarly journals Urinary tract infection pocket card effect on preferred antimicrobial prescribing for cystitis among patients discharged from the emergency department

Author(s):  
Mark Anthony Mixon ◽  
Scott Dietrich ◽  
Benjamin Bushong ◽  
Gary Peksa ◽  
Ryan Rogoszewski ◽  
...  

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose To evaluate the impact of a urinary tract infection (UTI) pocket card on preferred antibiotic prescribing for patients discharged from the emergency department (ED) with a diagnosis of cystitis. Methods A multicenter, retrospective, pre-post study was conducted to compare outcomes following the introduction of a UTI pocket card. The primary outcome was prescribing rates for institutional first-line preferred antibiotics (cephalexin and nitrofurantoin) versus other antimicrobials for cystitis. Secondary outcomes included prescriber adherence to recommended therapy in regards to discharge dose, frequency, duration, and healthcare utilization rates. Results The study included 915 patients in total, 407 in the preintervention group and 508 in the postintervention group. The frequency of preferred antibiotic prescribing was significantly increased after the introduction of a UTI pocket card compared to prior to its introduction (81.7% vs 72.0%, P = 0.001). Significant increases in prescribing of an appropriate antibiotic dose (78.0% vs 66.8%, P < 0.0001) and frequency (64.2% vs 47.4%, P < 0.0001) were also found post intervention. No significant differences were seen between the pre- and postintervention groups with regards to healthcare utilization rates. Conclusion A UTI pocket card increased preferred antibiotic prescribing for cystitis in the ED. This study provides data on a successful antimicrobial stewardship intervention in the ED setting.

2009 ◽  
Vol 16 (6) ◽  
pp. 500-507 ◽  
Author(s):  
Jeffrey M. Caterino ◽  
Sarah Grace Weed ◽  
Janice A. Espinola ◽  
Carlos A. Camargo, Jr

2017 ◽  
Vol 38 (8) ◽  
pp. 998-1001 ◽  
Author(s):  
Taniece Eure ◽  
Lisa L. LaPlace ◽  
Richard Melchreit ◽  
Meghan Maloney ◽  
Ruth Lynfield ◽  
...  

We assessed the appropriateness of initiating antibiotics in 49 nursing home (NH) residents receiving antibiotics for urinary tract infection (UTI) using 3 published algorithms. Overall, 16 residents (32%) received prophylaxis, and among the 33 receiving treatment, the percentage of appropriate use ranged from 15% to 45%. Opportunities exist for improving UTI antibiotic prescribing in NH.Infect Control Hosp Epidemiol 2017;38:998–1001


2021 ◽  
Vol 2 (4) ◽  
pp. 11
Author(s):  
Hemmat M. El-bana ◽  
Hanan A. Ali

Contents: The most prevalent type of infection during pregnancy is urinary tract infections (UTIs). It affects up to ten percent of pregnant women and may cause serious adverse pregnancy outcomes for both mother and fetus. Aim:  The research aimed to evaluate the effect of an educational intervention on pregnant women’s knowledge and self-care practices regarding urinary tract infection.  Methods: A quasi-experimental (pre/post-test) design was adopted to fulfill this study's aim. The study was conducted at the Obstetrics and Gynaecological outpatient clinic in Benha university hospital on a purposive sample of 68 pregnant women among those attending the setting mentioned above. Two key instruments were used to collect data: A structured interviewing questionnaire, self-care practices checklist. Results: revealed a highly statistically significant difference in pregnant women's knowledge and self-care practices related to urinary tract infection at post-intervention compared to their pre-intervention phase (p-values < 0.001). A highly significant positive correlation was illustrated between studied women's total knowledge and total practice scores at pre (p=0.04) and post-intervention (p=0.000) phases. Conclusion: The study concluded that the research hypothesis is supported, and pregnant women exhibited better knowledge and self-care practices regarding (UTI) during pregnancy after implementing an educational intervention than before. The study recommended that knowledge and self-care concepts regarding UTI through antenatal screening programs in early pregnancy should be empowered as an essential part of all women's health care levels and strategies.


2022 ◽  
Vol 23 (2) ◽  
pp. 870
Author(s):  
Anna Kawalec ◽  
Danuta Zwolińska

The microbiome of the urinary tract plays a significant role in maintaining health through the impact on bladder homeostasis. Urobiome is of great importance in maintaining the urothelial integrity and preventing urinary tract infection (UTI), as well as promoting local immune function. Dysbiosis in this area has been linked to an increased risk of UTIs, nephrolithiasis, and dysfunction of the lower urinary tract. However, the number of studies in the pediatric population is limited, thus the characteristic of the urobiome in children, its role in a child’s health, and pediatric urologic diseases are not completely understood. This review aims to characterize the healthy urobiome in children, the role of dysbiosis in urinary tract infection, and to summarize the strategies to modification and reshape disease-prone microbiomes in pediatric patients with recurrent urinary tract infections.


2018 ◽  
Vol 5 (6) ◽  
Author(s):  
Sarah C J Jorgensen ◽  
Samantha L Yeung ◽  
Mira Zurayk ◽  
Jill Terry ◽  
Maureen Dunn ◽  
...  

Abstract Background The complex and fast-paced emergency department (ED) practice setting presents unique challenges that demand a tailored approach to antimicrobial stewardship. In this article, we describe the strategies applied by 1 institution’s antimicrobial stewardship program (ASP) that were successful in improving prescribing practices and outcomes for urinary tract infection (UTI) in the ED. Methods Core strategies included pre-implementation research characterizing the patient population, antimicrobial resistance patterns, prescribing behavior, and morbidity related to infection; collaboration across multiple disciplines; development and implementation of a UTI treatment algorithm; education to increase awareness of the algorithm and the background and rationale supporting it; audit and feedback; and early evaluation of post-implementation outcomes. Results We observed a rapid change in prescribing post-implementation with increased empiric nitrofurantoin use and reduced cephalosporin use (P &lt; .05). Our elevation of nitrofurantoin to firstline status was supported by our post-implementation analysis showing that its use was independently associated with reduced 30-day return visits (adjusted odds ratio, 0.547; 95% confidence interval, 0.312–0.960). Furthermore, despite a shift to a higher risk population and a corresponding decrease in antimicrobial susceptibility rates post-implementation, the preferential use of nitrofurantoin did not result in higher bug-drug mismatches while 30-day return visits to the ED remained stable. Conclusions We demonstrate that an outcomes-based ASP can impart meaningful change to knowledge and attitudes affecting prescribing practices in the ED. The success of our program may be used by other institutions as support for ASP expansion to the ED.


2021 ◽  
Vol 28 (5) ◽  
pp. 290-297
Author(s):  
Shridevi Singh ◽  
L. D. George Angus ◽  
Swapna Munnangi ◽  
Dooniya Shaikh ◽  
Jody C. Digiacomo ◽  
...  

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