scholarly journals Cost effective analysis of tab. nitrofurantoin vs. inj. ceftriaxone as an empirical therapy in patients of urinary tract infection at a tertiary health care centre

2018 ◽  
Vol 7 (12) ◽  
pp. 2393
Author(s):  
Nikhil S. Yadav ◽  
Swanand S. Pathak
Keyword(s):  
Health Care ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Empirical Therapy ◽  
Cost Effective ◽  
Cost Of Care ◽  
Total Cost ◽  
Tract Infections ◽  
The Cost

Background: Urinary tract infections (UTI) are commonly seen in adults, Urinary tract infection and asymptomatic bacteriuria in adults are a significant health care burden. In a developing country it is necessary to minimize the cost of therapy while giving maximum health benefits to the patient. Appropriate antimicrobial selection is clearly important, as treatment failures will increase the cost of care and result in additional morbidity for patients. Empirical treatment of urinary tract infection is common at tertiary health care center, authors conducted a pharmacoeconomic study to evaluate cost effectiveness of the empirical treatment.Methods: Patients with similar symptoms suffering from UTI were divided into 5 groups with 10 patients in each group. Each group was subdivided into two subgroups with subgroup A having five patients receiving tab nitrofurantoin and subgroup B having 5 patients receiving inj ceftriaxone. Out of the total cost of therapy, percentage of cost attributed to tab nitrofurantoin was compared with inj ceftriaxone. Most cost-effective antibiotic was analysed. Average number of admission days for groups of UTI patients receiving tab nitrofurantoin and inj ceftriaxone were calculated and compared. Group of UTI patients receiving antibiotic with least number of admission days was calculated.Results: Percentage of cost attributed to Nitrofurantoin therapy out of total cost in urinary tract infection patient was less than percentage of cost attributed to inj Ceftriaxone in all five groups of patients and was found to be statistically significant (p <0.05). However, there was no statistically significant difference in average number of admission (IPD) days between groups of patients receiving tab nitrofurantoin and inj ceftriaxone (p>0.05).Conclusions: In current study authors found tab nitrofurantoin to be more cost effective than inj ceftriaxone as an empirical therapy in UTI patients.

scholarly journals Detection of urinary tract infections by rapid methods.

1988 ◽  
Vol 1 (3) ◽  
pp. 268-280 ◽  
Author(s):  
M Pezzlo
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Patient Population ◽  
Cost Effective ◽  
Culture Method ◽  
Diagnostic Laboratory ◽  
Patient Groups ◽  
Tract Infections ◽  
Selection Of

A review of rapid urine screens for detection of bacteriuria and pyuria demonstrates a number of available alternatives to the culture method. Selection of one or more of these systems for routine use is dependent upon the laboratory and the patient population being tested. The laboratory approach to the diagnosis of urinary tract infection should consider the clinical diagnosis of the patient whenever possible. Keeping in mind that quantitative urine cultures alone cannot be used to detect infection in some patient populations unless lower colony counts are considered, a rapid screen may be a more practical approach. It has become accepted that 10(5) CFU/ml can no longer be used as the standard for all patient groups, that pyuria often is important in making the diagnosis of a urinary tract infection, and that most of the rapid screens are more sensitive than the culture method at 10(5) CFU/ml. Presently, no one approach can be recommended for all laboratories and all patient groups. However, each diagnostic laboratory should select one approach which is best for its situation. It is not practical, efficient, or cost effective to define a protocol for each possible clinical condition; however, all should be considered when developing a protocol. This protocol should be compatible with the patient population and communicated to the physicians. Use of a rapid screen should be beneficial to the patient, the physician, and the laboratory.

Bacterial Agents and Their Antibiotic Susceptibility in Urinary Tract Infection (UTI) of Pediatric Age Group

2019 ◽  
Vol 9 (4) ◽  
pp. 401-407
Author(s):  
Mohd Rafiq Lone*,Nisar Ahmad Ganie,Mohsin Rashid, Syed Muneeb Mohammad,Javid Ahmad,Nazir Ahmad Parray
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antimicrobial Susceptibility ◽  
Antibiotic Susceptibility ◽  
Empirical Therapy ◽  
Klebsiella Species ◽  
E Coli ◽  
Tract Infections

Background: Urinary tract infections (UTIs) account for one of the common cause of hospital visits and therefore determination of the antimicrobial susceptibility patterns of uropathogens will help guide physicians to choice the best choice of antibiotics to affected patients. The aim of this study was to isolate the bacteriological agent causing the urinary tract infection and determination of their susceptibility to antibiotics. Methods: Our study was hospital based prospective study in which patients suspected of UTI were admitted and urine sample were collected using ‘urinary catheter’ method in patients less than 3 years of age, while for older children ‘mid stream clean catch’ method was used. Cultures were bacteriologically analyzed using standard microbiological procedures and antimicrobial susceptibility test was performed for the isolated pathogens.Results: 208 patients with suspected UTI were included in study, out of 208 patients, urine cultures were taken from all patients, 38 cultures (18.2%) were reported as positive. The most common pathogens isolated were Escherichia coli 27 (71%), Klebsiella Species 6 (15%), Enterococcussps 3(7.8%), Proteus sps 1(2.6%), Pseudomonas aeruginosa 1(2.6%). E. coli and Klebsiella showed the highest percentage of resistance to amoxicillin and ampicillin (100%) however, all isolates of E. coli and Klebsiella were susceptible to Nitofurantoin. Among all UTI isolates, least resistance was observed against drugs such as ceftriaxone, cefixime ciproflaxacilin and gentamicin. Conclusion: The finding of our study showed that E. Coli was the most common uropathogen and there was high resistance to routinely used drugs in clinical practice. So it high time to change the empirical therapy from conventional drugs like ampicillin and amoxicillin to drugs like nitrofurantoin or ciprofloxacilin. Keywords: Urinary tract infection, urine culture, antibiotic susceptibility.

Management Criteria, Documentation, and Peer Review of Initial Urinary Tract Infection

PEDIATRICS ◽  
1976 ◽  
Vol 57 (5) ◽  
pp. 754-759
Author(s):  
Andrew M. Margileth ◽  
Hugh C. Thompson ◽  
Charles E. Osborne ◽  
Keyword(s):  
Health Care ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Medical Care ◽  
Peer Review ◽  
Care Process ◽  
National Study ◽  
Chart Audit ◽  
Tract Infections

During part of a national study to formulate criteria for chart audit of quality assurance of child health care, criteria were developed for diagnosis and management of urinary tract infections. These criteria were validated by pediatricians and family physicians in academic medicine and in practice. They were judged relevant to the medical care process and patient outcome by both. The selected criteria were also recommended by the majority of two large physician groups for use in peer review. An important aspect of the study assessed the frequency of performing and recording indicated procedures or tests. In the first three phases of the study these criteria were said to be performed and recorded by a large majority of physicians. However, in the fourth (community) phase, when charts of 166 primary care physicians were actually audited, documentation was so poor that peer review by chart audit would be impractical at present. Assuming proper documentation of the medical care process, similar criteria could be used for chart audit, clinical research, and educational purposes. Since the diagnostic and management process of initial urinary tract infection is established, development of structured health care forms and education in proper record-keeping are two important challenges for those interested in the evaluation of ambulatory care.

scholarly journals Impact of the 2012 Medicaid Health Care–Acquired Conditions Policy on Catheter-Associated Urinary Tract Infection and Vascular Catheter–Associated Infection Billing Rates

2018 ◽  
Vol 5 (9) ◽  
Author(s):  
Chanu Rhee ◽  
Rui Wang ◽  
Maximilian S Jentzsch ◽  
Heather Hsu ◽  
Alison Tse Kawai ◽  
...  
Keyword(s):  
Health Care ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Billing Data ◽  
Tract Infections

Abstract In July 2012, the Centers for Medicare & Medicaid Services ceased hospital Medicaid reimbursements for certain health care–acquired conditions. Using billing data from 2008–2014, we found no impact of this policy on rates of 2 targeted conditions, vascular catheter–associated infections and catheter-associated urinary tract infections, among Medicaid or non-Medicaid patients.

Nosocomial Urinary Tract Infection: A Prospective Evaluation of 108 Catheterized Patients

1981 ◽  
Vol 2 (5) ◽  
pp. 380-386 ◽  
Author(s):  
Alan I. Hartstein ◽  
Susan B. Garber ◽  
Thomas T. Ward ◽  
Stephen R. Jones ◽  
Virginia H. Morthland
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Cost Effective ◽  
Disease Status ◽  
Nosocomial Urinary Tract Infection ◽  
Effective Manner ◽  
Tract Infections ◽  
Major Emphasis

AbstractThis study describes the evaluation of 108 patients who had indwelling urethral catheters for acute medical and surgical indications. Patients were evaluated daily, and cultures from bladders and drainage bags were obtained. Appropriateness for continuing catheterization was assessed using preset criteria. Twenty-five patients developed urinary tract infections. Exposure to antibiotics and a shorter duration of catheterization were the only factors that correlated significantly with a delayed onset or decreased prevalence of infection. Factors found to have insignificant effects included age, sex, maintenance of the closed system, underlying host disease status, catheter type, and reason for catheterization. No collection systems with one way valves were used, but significant colony counts in drainage bag urine preceded urinary tract infection in only two patients. Thirty-six percent of the total 562 catheter days were judged unnecessary. A major emphasis must be placed on prompt catheter removal if the prevalence of nosocomial urinary tract infections is to be reduced substantially in a cost-effective manner [Infect Control 1981; 2(5):380-386.]

scholarly journals HEALTH CARE ASSOCIATED URINARY TRACT INFECTIONS IN DEPARTMENT OF MEDICINE

2019 ◽  
Vol 3 (10) ◽  
Author(s):  
Dr. Fateh Singh Sinsinwar ◽  
Dr. Nitin Chauhan
Keyword(s):  
Health Care ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Hospital Environment ◽  
Additional Patient ◽  
Klebsiella Pneumonia ◽  
Activity Restriction ◽  
Health Care Associated Infections ◽  
Tract Infections

Introduction:  Health care associated infections (HCAIs) or hospital acquired infections (HAIs) are infections that occur during hospitalization but they are neither present nor incubating before hospital admission. Health care–associated urinary tract infection (UTI) is an important cause of morbidity and increased health care costs in hospitals. Rapid advances in medical field, injudicious use of antibiotics and better adaptation of organisms to the hospital environment contribute to increase in HAIs. There are additional patient safety concerns associated with urinary catheter insertion, like patient discomfort, activity restriction, discharge delays, and the potential development of a reservoir of multidrug-resistant organisms that can be spread to other patient.  Material and Methods: Patients admitted in wards of medicine department were included in the present study. Patients who were admitted for at least for past 48 hours, or readmitted in less than 14 days after their discharge from hospital. Sociodemographic data from all the included patients was collected from medical records. Clinical history was obtained from all the patients. Signs of HAI were observed and recorded. Bacteremia was defined as presence of bacteria in the blood confirmed by at least one positive blood culture. Results: A total of 238 patients were included in the study who were admitted in the medicine wards. Out of 238 patients included in the study, 31 (13.02%) presented one or several signs suggestive of HAI and they received microbiological tests. 20 (8.40%) cases were confirmed or potential HAI. Of the 238 patients 109 (54.20%) were male and 129 (45.79%) were female. 31 patients were diagnosed as HAI patients of which 14 (45.16%) were male and 17 (54.83%) were female. Mean age of HAI patients was 54.21 ± 17.41while total mean of age was 46.52 ± 16.74. Mean age of male with HAI 52.41 ± 19.53 and female was 53.46 ± 16.77. Of the total 7 culture positive patients with HAI   Escherichia coli was isolated in 3 cases, Klebsiella pneumonia in 2 caesa, Pseudomonas aeruginosa and Staphylococcus aureus were isolated in 1 cases each. Conclusion: Prevalence of HAI in Urinary tract infection was 13.02% in this study. Preventive measures, periodic active surveillance over a longer period is required to reduce the rate of healthcare associated UTI. Keywords: UTI, HAI, Health care associated infections, Catheter-associated UTI

Optimizing Diagnostic Test Sequences: The Probability Modifying Plot

1999 ◽  
Vol 38 (01) ◽  
pp. 50-55 ◽  
Author(s):  
P. F. de Vries Robbé ◽  
A. L. M. Verbeek ◽  
J. L. Severens
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Decision Trees ◽  
Diagnostic Tests ◽  
Test Sequence ◽  
Optimal Sequence ◽  
Specific Test ◽  
Total Cost ◽  
Modelling Techniques

Abstract:The problem of deciding the optimal sequence of diagnostic tests can be structured in decision trees, but unmanageable bushy decision trees result when the sequence of two or more tests is investigated. Most modelling techniques include tests on the basis of gain in certainty. The aim of this study was to explore a model for optimizing the sequence of diagnostic tests based on efficiency criteria. The probability modifying plot shows, when in a specific test sequence further testing is redundant and which costs are involved. In this way different sequences can be compared. The model is illustrated with data on urinary tract infection. The sequence of diagnostic tests was optimized on the basis of efficiency, which was either defined as the test sequence with the least number of tests or the least total cost for testing. Further research on the model is needed to handle current limitations.

Risk Factors in Diabetes and Pregnant Women with Urinary Tract Infections Compared to Younger Aged Female.

2018 ◽  
Vol 1 (3) ◽  
pp. 26-38
Author(s):  
Abdulghani Mohamed Alsamarai ◽  
Shler Ali Khorshed
Keyword(s):  
Risk Factors ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Pregnant Women ◽  
Female Student ◽  
Mean Value ◽  
Infected Female ◽  
Significant Difference ◽  
Tract Infections

Background: Urinary tract infection is common with health impact in women and characterised by failure to treatment and recurrent episodes. Aim: This study was conducted to determine the risk factors for the development of urinary tract infection in diabetic and pregnant women in comparison to student female. Materials and methods: A prospective cross-sectional study conducted during the period from 1st of June 2015 to the end of January 2016. The population included in the study are 563 women, of them 425 were outpatients, and 138 were inpatients. Their age range between 18 and 80 years, with a mean age of 33.59±15.29 years. Urine samples collected and cultured on blood agar and MacConkey agar by spread plate technique. Bacterial colonies with different morphology were selected, purified and identified according to their biochemical characteristics using conventional standard methods. Results: In diabetic women, there were no significant difference in mean age and BMI values between culture positive and culture negative groups. However, pus cell mean scale was significantly higher [P=0.000] in women with urinary tract infection [1.76±1.25] than in those with negative culture [0.69±1.00]. In pregnant women, BMI mean value was significantly [P=0.013] lower in pregnant women with UTI [26.14] as compared to those without infection [26.99]. Pus cell scale mean value was significantly [P=0.000] higher in pregnant women with UTI [1.55] than women with negative UTI [0.85]. While there was no significant difference in mean age between UTI positive and negative pregnant women. In female student, there was a significant difference between UTI infected and non-infected in mean age [P=0.041] and pus cell scale [P=0.000]. However, BMI was not significantly different between infected and non-infected female student. Other risk factors association are variables in the 3 groups when analysed using X2, while AUC and OR show different trends of association between risk factors and UTI. Conclusion: BMI, pus cell scale, child number, delivery method, operation history and hospital setting were significantly associated with culture positivity in the 3 studied groups as determined by AUC. While OR confirmed association with pus sale scale in the 3 groups.

Detection of tox A gene in Pseudomonas aeruginosa that isolates from different clinical cases by using PCR.

2018 ◽  
pp. 26
Author(s):  
Rana M. Abdullah Al-Shwaikh ◽  
Abbas Falih Alornaaouti
Keyword(s):  
Molecular Weight ◽  
Pseudomonas Aeruginosa ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Otitis Media ◽  
Urinary Tract Infections ◽  
Gel Electrophoresis ◽  
Wound Infections ◽  
Tract Infections

       Current study obtained (75) isolate of Pseudomonas aeruginosa collected from different cases included : 28 isolates from otitis media, 23 isolates from burn infections, 10 isolates from wound infections, 8 isolates from urinary tract infections and 6 isolates from blood, during the period between 1/9/2014 to 1/11/2014        The result revealed that the tox A gene was present in 54 isolates (72%) of Pseudomonas aeruginosa. The gel electrophoresis showed that the molecular weight of tox A gene was 352 bp. The result shows 17 isolates (60.71%) from otitis media has tox A gene, 18 isolates (78.26%) from burn followed by 8 isolate (80%) from wound infection and 5 isolates (62.5%) from urinary tract infection , finally 6 isolates (100%) from blood have this gene.

URINARY INFECTION AT DEPARTMENT OF UROLOGY OF HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

2018 ◽  
pp. 100-108
Author(s):  
Dinh Khanh Le ◽  
Dinh Dam Le ◽  
Khoa Hung Nguyen ◽  
Xuan My Nguyen ◽  
Minh Nhat Vo ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Urinary Tract Infections ◽  
Urine Culture ◽  
Clinical Manifestations ◽  
University Hospital ◽  
E Coli ◽  
Positive Urine ◽  
Tract Infections

Objectives: To investigate clinical characteristics, bacterial characteristics, drug resistance status in patients with urinary tract infections treated at Department of Urology, Hue University Hospital. Materials and Method: The study was conducted in 474 patients with urological disease treated at Department of Urology, Hue Universiry Hospital from July 2017 to April 2018. Urine culture was done in the patients with urine > 25 Leu/ul who have symptoms of urinary tract disease or infection symptoms. Patients with positive urine cultures were analyzed for clinical and bacterial characteristics. Results: 187/474 (39.5%) patients had symptoms associated with urinary tract infections. 85/474 (17.9%) patients were diagnosed with urinary tract infection. The positive urine culture rate was 45.5%. Symptoms of UTI were varied, and no prominent symptoms. E. coli accounts for the highest proportion (46.67%), followed by, Staphycoccus aureus (10.67%), Pseudomonas aeruginsa (8,0%), Streptococcus faecali and Proteus (2.67%). ESBL - producing E. coli was 69.23%, ESBL producing Enterobacter spp was 33.33%. Gram-negative bacteria are susceptible to meropenem, imipenem, amikacin while gram positive are vancomycin-sensitive. Conclusions: Clinical manifestations of urinary tract infections varied and its typical symptoms are unclear. E.coli is a common bacterium (46.67%). Isolated bacteria have a high rate of resistance to some common antibiotics especially the third generation cephalosporins and quinolones. Most bacteria are resistant to multiple antibiotics at the same time. Gram (+) bacteria are susceptible to vancomycin, and gram (-) bacteria are susceptible to cefoxitin, amikacin, and carbapenem. Key words: urinary tract infection

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