NDLI: Overprescribing antibiotics for asymptomatic bacteriuria in older adults: a case series review of admissions in two UK hospitals

Content Provider	Springer Nature : BioMed Central
Author	Rousham, Emily Cooper, Michael Petherick, Emily Saukko, Paula Oppenheim, Beryl
Abstract	Background Overdiagnosis and overtreatment of urinary tract infection (UTI) with antibiotics is a concern. In older adults, diagnosis of UTI using near-patient urine tests (reagent strip tests, dipsticks) is advised against because the age-related increase in asymptomatic bacteriuria can cause false-positive results. Instead, UTI diagnosis should be based on a full clinical assessment. Previous research lacks systematic information on urine dipstick use in hospitals. The aim of this study was to examine the use of urine dipstick tests and microbiology among older adult hospital admissions in relation to recommended UTI diagnostic criteria. A further aim was to assess factors associated with the use of dipsticks. Methods A case series review of patients aged ≥70 years admitted to two NHS Trust hospitals in England. Records from 312 patients admitted in 2015 meeting inclusion criteria were selected at random. Results Of 298 complete patient records, 54% had at least one urine dipstick test recorded. 13% (21/161) of patients who received a urine dipstick test were diagnosed as having a UTI, only 2 out of these 21 cases had two or more clinical signs and symptoms. 60 patients received a second dipstick test, leading to 13 additional cases of UTI diagnosis. Dipstick tests were more likely to be performed on patients with a history of falls (OR 1.93, 95% CI:1.21, 3.07, p < 0.01), and less likely on those with dementia (OR 0.44, 95% CI: 0.22, 0.87, p < 0.05). The most common reason for testing was routine admissions policy (49.1% of cases), but these cases were predominantly in one hospital. Conclusions Use of urine dipstick tests was high among older adults admitted to hospitals. Most cases were asymptomatic and therefore received inappropriate antibiotic therapy. This paper highlights the need to implement new Public Health England diagnostic guidelines to hospital admission and emergency departments.
Related Links	https://aricjournal.biomedcentral.com/counter/pdf/10.1186/s13756-019-0519-1.pdf
Ending Page	8
Page Count	8
Starting Page	1
File Format	HTM / HTML
ISSN	20472994
DOI	10.1186/s13756-019-0519-1
Journal	Antimicrobial Resistance & Infection Control
Issue Number	1
Volume Number	8
Language	English
Publisher	BioMed Central
Publisher Date	2019-05-02
Access Restriction	Open
Subject Keyword	Medical Microbiology Drug Resistance Infectious Diseases Urinary tract infection Diagnosis Antimicrobial agents Antibiotic resistance Guidelines
Content Type	Text
Resource Type	Article
Subject	Public Health, Environmental and Occupational Health Infectious Diseases Microbiology (medical) Pharmacology (medical)
Journal Impact Factor	4.8/2023
5-Year Journal Impact Factor	5.8/2023

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

Urinary Tract Infection and Asymptomatic Bacteriuria in Older Adults

Gaps in communication between different staff groups and older adult patients foster unnecessary antibiotic prescribing for urinary tract infections in hospitals: a qualitative translation approach

Current Pyuria Cutoffs Promote Inappropriate Urinary Tract Infection Diagnosis in Older Women.

Diagnosis and management of urinary tract infection in older adults.

Catheter associated urinary tract infections

1106. Assessment of Fluoroquinolone Appropriateness for Hospitalized Patients with Asymptomatic Bacteriuria and Cystitis: A Multi-Hospital Cohort Study

Why is asymptomatic bacteriuria overtreated?: A tertiary care institutional survey of resident physicians

1676. Evaluation of Antibiotic Overuse for Asymptomatic Bacteriuria in a Hospital with Low Baseline Antibiotic Use

Management of catheter-associated urinary tract infection

Overprescribing antibiotics for asymptomatic bacteriuria in older adults: a case series review of admissions in two UK hospitals

Similar Documents

Urinary Tract Infection and Asymptomatic Bacteriuria in Older Adults

Gaps in communication between different staff groups and older adult patients foster unnecessary antibiotic prescribing for urinary tract infections in hospitals: a qualitative translation approach

Current Pyuria Cutoffs Promote Inappropriate Urinary Tract Infection Diagnosis in Older Women.

Diagnosis and management of urinary tract infection in older adults.

Catheter associated urinary tract infections

1106. Assessment of Fluoroquinolone Appropriateness for Hospitalized Patients with Asymptomatic Bacteriuria and Cystitis: A Multi-Hospital Cohort Study

Why is asymptomatic bacteriuria overtreated?: A tertiary care institutional survey of resident physicians

1676. Evaluation of Antibiotic Overuse for Asymptomatic Bacteriuria in a Hospital with Low Baseline Antibiotic Use

Management of catheter-associated urinary tract infection

Overprescribing antibiotics for asymptomatic bacteriuria in older adults: a case series review of admissions in two UK hospitals