Urinary Tract Infection Stewardship: A Urinary Antibiogram and Electronic Medical Record Alert Nudging Narrower-Spectrum Antibiotics for Urinary Tract Infections

Department

Infectious Diseases

Document Type

Article

Publication Title

Antimicrobial Stewardship and Healthcare Epidemiology

Abstract

An antimicrobial stewardship intervention consisting of a urinary antibiogram and an electronic health record best-practice advisory promoted narrower-spectrum antibiotics for uncomplicated urinary tract infections in hospitalized patients. Over 20 months, the intervention significantly reduced ceftriaxone orders by 48% (P < .001) and increased cefazolin use 19 times from baseline (P < .001).

Urinary tract infections (UTIs) are the second most common indication for inpatient antibiotics in the United States1, making them a prime target for antimicrobial stewardship programs (ASPs). The 2010 Infectious Diseases Society of America guidelines for acute uncomplicated cystitis recommend narrow-spectrum antibiotics (NSAs)2, yet many hospitalized patients receive broad-spectrum antibiotics (BSAs)1. To reduce BSA use, such as third-generation cephalosporins, and to promote first-generation cephalosporin use for uncomplicated UTIs, we developed a urinary antibiogram and an electronic health record (EHR) best-practice advisory (BPA). We then measured their impact on antibiotic prescriptions for UTIs.

First Page

e8

DOI

10.1017/ash.2021.163

Volume

1

Issue

1

Publication Date

6-29-2021

Comments

See full list of authors at journal website.

PubMed ID

36168507

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