Applying Diagnostic Stewardship to Proactively Optimize the Management of Urinary Tract Infections
A urinary tract infection is amongst the most common bacterial infections in the community and hospital setting and accounts for an estimated 1.6 to 2.14 billion in national healthcare expenditure. Despite its financial impact, the diagnosis is challenging with urine cultures and antibiotics often i...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Antibiotics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-6382/11/3/308 |
| _version_ | 1797473271643373568 |
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| author | Faiza Morado Darren W. Wong |
| author_facet | Faiza Morado Darren W. Wong |
| author_sort | Faiza Morado |
| collection | DOAJ |
| description | A urinary tract infection is amongst the most common bacterial infections in the community and hospital setting and accounts for an estimated 1.6 to 2.14 billion in national healthcare expenditure. Despite its financial impact, the diagnosis is challenging with urine cultures and antibiotics often inappropriately ordered for non-specific symptoms or asymptomatic bacteriuria. In an attempt to limit unnecessary laboratory testing and antibiotic overutilization, several diagnostic stewardship initiatives have been described in the literature. We conducted a systematic review with a focus on the application of molecular and microbiological diagnostics, clinical decision support, and implementation of diagnostic stewardship initiatives for urinary tract infections. The most successful strategies utilized a bundled, multidisciplinary, and multimodal approach involving nursing and physician education and feedback, indication requirements for urine culture orders, reflex urine culture programs, cascade reporting, and urinary antibiograms. Implementation of antibiotic stewardship initiatives across the various phases of laboratory testing (i.e., pre-analytic, analytic, post-analytic) can effectively decrease the rate of inappropriate ordering of urine cultures and antibiotic prescribing in patients with clinically ambiguous symptoms that are unlikely to be a urinary tract infection. |
| first_indexed | 2024-03-09T20:12:23Z |
| format | Article |
| id | doaj.art-2fea4625ceb04780a355c6ed79610d8b |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-09T20:12:23Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-2fea4625ceb04780a355c6ed79610d8b2023-11-24T00:10:27ZengMDPI AGAntibiotics2079-63822022-02-0111330810.3390/antibiotics11030308Applying Diagnostic Stewardship to Proactively Optimize the Management of Urinary Tract InfectionsFaiza Morado0Darren W. Wong1Department of Pharmacy, Keck Medical Center, University of Southern California (USC), Los Angeles, CA 90033, USADivision of Infectious Diseases, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA 90033, USAA urinary tract infection is amongst the most common bacterial infections in the community and hospital setting and accounts for an estimated 1.6 to 2.14 billion in national healthcare expenditure. Despite its financial impact, the diagnosis is challenging with urine cultures and antibiotics often inappropriately ordered for non-specific symptoms or asymptomatic bacteriuria. In an attempt to limit unnecessary laboratory testing and antibiotic overutilization, several diagnostic stewardship initiatives have been described in the literature. We conducted a systematic review with a focus on the application of molecular and microbiological diagnostics, clinical decision support, and implementation of diagnostic stewardship initiatives for urinary tract infections. The most successful strategies utilized a bundled, multidisciplinary, and multimodal approach involving nursing and physician education and feedback, indication requirements for urine culture orders, reflex urine culture programs, cascade reporting, and urinary antibiograms. Implementation of antibiotic stewardship initiatives across the various phases of laboratory testing (i.e., pre-analytic, analytic, post-analytic) can effectively decrease the rate of inappropriate ordering of urine cultures and antibiotic prescribing in patients with clinically ambiguous symptoms that are unlikely to be a urinary tract infection.https://www.mdpi.com/2079-6382/11/3/308diagnostic stewardshipantimicrobial stewardshipurinary tract infection |
| spellingShingle | Faiza Morado Darren W. Wong Applying Diagnostic Stewardship to Proactively Optimize the Management of Urinary Tract Infections Antibiotics diagnostic stewardship antimicrobial stewardship urinary tract infection |
| title | Applying Diagnostic Stewardship to Proactively Optimize the Management of Urinary Tract Infections |
| title_full | Applying Diagnostic Stewardship to Proactively Optimize the Management of Urinary Tract Infections |
| title_fullStr | Applying Diagnostic Stewardship to Proactively Optimize the Management of Urinary Tract Infections |
| title_full_unstemmed | Applying Diagnostic Stewardship to Proactively Optimize the Management of Urinary Tract Infections |
| title_short | Applying Diagnostic Stewardship to Proactively Optimize the Management of Urinary Tract Infections |
| title_sort | applying diagnostic stewardship to proactively optimize the management of urinary tract infections |
| topic | diagnostic stewardship antimicrobial stewardship urinary tract infection |
| url | https://www.mdpi.com/2079-6382/11/3/308 |
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