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Simple lab-based change may help reduce unnecessary antibiotic therapy, improve care
Date:2/26/2014

[EMBARGOED UNTIL THURSDAY, FEB. 27] 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 inpatientsthose at lower risk for developing a UTIwere 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 groupwhose culture results were routinely reported as beforeremained
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Contact: Jerica Pitts
jpitts@pcipr.com
312-558-1770
Infectious Diseases Society of America
Source:Eurekalert

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