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Continuation of Antibiotics for UTI Often Inappropriate

Posted on Sun, Nov 22, 2015
Continuation of Antibiotics for UTI Often Inappropriate

Antibiotics frequently initiated inappropriately in ER; continuation after admission inappropriate for 68%

For patients with urinary tract infections (UTIs), initiation of antibiotics in the emergency department is frequently inappropriate, as is continuation of antibiotics after admission, according to a study published online Nov. 12 in the Journal of Hospital Medicine.

Dmitry Kiyatkin, M.D., from the Johns Hopkins Bayview Medical Center in Baltimore, and colleagues reviewed the medical records for all patients admitted to the hospital who initiated treatment for a UTI in the emergency department during a four-week period.

The researchers found that antibiotic initiation was inappropriate for 59 percent of 94 patients. Continuation of antibiotics after admission was inappropriate for 68 percent of 80 patients.

"In conclusion, we found a high rate of inappropriate antibiotic administration for UTIs that began in the emergency department and continued after admission," the authors write. "Specific guidelines should be developed and validated to direct diagnosis and treatment of UTIs in the emergency department and hospital."

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Strategies Needed to Encourage Appropriate Antibiotic Selection

Posted on Sat, Dec 06, 2014
Strategies Needed to Encourage Appropriate Antibiotic Selection

Primary care providers do not always comply with guideline recommendations for antibiotic selection

MONDAY, Nov. 24, 2014 (HealthDay News) -- Although primary care providers are generally familiar with guideline recommendations for antibiotic drug selection, they do not always comply with these guidelines, according to research published in the December issue of the U.S. Centers for Disease Control and Prevention'sEmerging Infectious Diseases.

Guillermo V. Sanchez, M.P.H., from the CDC in Atlanta, and colleagues conducted in-depth interviews with 36 primary care providers to explore knowledge, attitudes, and self-reported practices regarding antibiotic drug resistance and appropriate drug selection.

The researchers found that participants were generally familiar with antibiotic drug selection guidelines for common infections, but did not always comply with these guidelines. The belief that non-recommended agents are more likely to cure an infection, concern for patient or parent satisfaction, and fear of infectious complications were cited as reasons for nonadherence. Providers were inconsistent in their definition of broad- and narrow-spectrum antibiotic agents. Although widespread concern was expressed in relation to antibiotic resistance, it was not generally addressed on selection of therapy.

"Future research efforts should be aimed at investigating effective incentives for appropriate antibiotic prescribing and determining alternative communication strategies to encourage use of first-line agents," the authors write. "Although most efforts have focused on reducing unnecessary antibiotic use, more research is needed to clarify which interventions improve antibiotic selection."

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