Antibiotics overused in emergency departments for suspected UTI

Research presented at a conference on clinical microbiology and infectious diseases suggests that many patients are given antibiotics for a urinary tract infection in emergency care when there is no evidence of an infection being present.

Dip stick for testing presence of a UTI

More than 60% of patients treated for urinary tract infection (UTI) lack evidence of the infection, a study carried out in a Birmingham emergency department has found[1]
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The research, presented at the European Congress of Clinical Microbiology and Infectious Diseases in Amsterdam, The Netherlands (13–16 April 2019), used the electronic health records of 943 patients who attended the emergency department with a suspected UTI, of whom 191 were diagnosed with lower UTI. There were also 56 cases diagnosed with pyelonephritis and 42 with urosepsis.

Overall, 91% of patients with lower UTIs received antibiotics. However, clinical and microbiological evidence of UTI was lacking in 64% of cases. Likewise, most patients with pyelonephritis and urosepsis received antibiotics, but clinical evidence was lacking in 61% and 74% of cases, respectively.

For those diagnosed with a UTI in the emergency department, antibiotics were stopped for 16% at admission and 23% within 72 hours of admission.

The researchers said that although the findings were only from a single hospital, there was scope to further reduce antibiotic prescribing for UTIs within other emergency departments.

“Our findings highlight the importance and potential impact of reviewing and revising antibiotic prescribing decisions as part of antimicrobial stewardship initiatives,” they concluded.

References

[1] Shallcross L, Rockenschaub P, McNulty D et al. Diagnosing urinary tract infection in the emergency department: a cohort study using electronic health records. Presented at ECCMID, Amsterdam, The Netherlands. 13–16 April 2019. Abstract available at: https://www.ucl.ac.uk/health-informatics/sites/health-informatics/files/eccmid_040419_laura_shallcross_.pdf (accessed May 2019)

Last updated
Citation
Clinical Pharmacist, CP, June 2019, Vol 11, No 6;11(6):DOI:10.1211/PJ.2019.20206543