1282. Quality of Antibiotic Use for Complicated Urinary Tract Infections: Large Variation Between 38 Dutch Hospital Departments
Session: Poster Abstract Session: Urinary Tract Infections
Saturday, October 22, 2011
Room: Poster Hall B1
Handouts
  • poster_baselinedata2.png (168.6 kB)
  • Background: The quality of antibiotic treatment in patients with complicated urinary tract infections (UTIs) can be evaluated using a valid set of nine quality indicators (QIs) (Clin Infect Dis 2008;46:703-11). The aim of the current study was to measure the performance on these QIs in the departments of Internal Medicine and Urology of 19 hospitals in the Netherlands.

    Methods: Included were in- and outpatients with complicated UTIs, who had been treated in 2007/2008 at Internal Medicine and Urology departments of 19 university and non-university Dutch hospitals. Data of 50 patients per department were retrospectively extracted from the medical charts. Performance on the QIs was calculated using previously constructed algorithms.

    Results: The study population consisted of 1,964 patients with a complicated UTI. Overall, the quality of antibiotic treatment showed a wide variation between departments and a considerable room for improvement. Median indicator performance varied between 26% and 77%, with the lowest median performance on the indicator “prescribe treatment for men in accordance with guidelines” (26%, range between departments 5% - 51%), and the highest on the indicator “perform a urine culture” (77%, range between departments 28% - 93%). For other indicators like “tailor treatment according to culture results” and “switch from iv. to oral therapy after 48-72 hours” there was also a wide inter department range.

    Conclusion:A large variation was demonstrated between 38 departments in their performance on the QIs. Analyses to identify determinants of this performance at the patient, department and hospital level will follow. Insight into these determinants is needed to develop targeted interventions to improve the quality of antibiotic care for patients with complicated UTIs.

     


    Subject Category: J. Clinical practice issues

    Veroniek Spoorenberg, MD1,2, Marlies E.J.L. Hulscher, PhD1, Ronald B. Geskus, PhD3, Jan M. Prins, Professor, MD2 and Suzanne Geerlings, MD, PhD2, (1)IQ Healthcare, Radboud Univ. Nijmegen Med. Ctr, Nijmegen, Netherlands, (2)Internal Med., Infectious Diseases, Tropical Med. and AIDS, Ctr. for Infection and Immunity Amsterdam (CINIMA), Academic Med. Ctr., Amsterdam, Netherlands, (3)Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Med. Ctr., Univ. of Amsterdam, Amsterdam, Netherlands

    Disclosures:

    V. Spoorenberg, None

    M. E. J. L. Hulscher, None

    R. B. Geskus, None

    J. M. Prins, None

    S. Geerlings, BMS,AstraZeneca Astellas: Scientific Advisor, Consulting fee

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.