1427. Retrospective, Multicenter, Point Prevalence Study of Urinary Tract Infection (UTI) Data for a City-Wide Antimicrobial Stewardship Initiative
Session: Poster Abstract Session: Antimicrobial Stewardship: Interventions
Saturday, October 10, 2015
Room: Poster Hall
Posters
  • IDWeek 2015 Poster 2.pdf (512.9 kB)
  • Background:

    Use of antimicrobials in patients with asymptomatic bacteriuria is a significant problem in acute care institutions. The purpose of this study was to evaluate antimicrobial prescribing practices for UTIs in the acute care setting before and after implementation of education aimed at reducing antimicrobial use for asymptomatic bacteriuria as part of an antimicrobial stewardship initiative.

    Methods:

    Four hospitals participated in a retrospective point prevalence survey using a standardized CDC endorsed chart audit tool. Data were captured on a single day at each hospital in January or February 2014 and on a single day in February 2015. Patients were included if they were receiving antimicrobial(s) for the treatment of UTI per order indication. Data collected included demographics, presenting symptoms, urinalysis and urine culture, empiric and pathogen-guided treatment and total inpatient duration of therapy. UTI symptoms were assessed based on McGeer criteria.

    Results:

    The total number of patients receiving antimicrobials with an indication of UTI was 75 in 2014 and 53 in 2015. The percentage of patients with no documented symptoms decreased from 23% in 2014 to 9% in 2015. In uncatheterized patients receiving antimicrobials for UTIs, there was no difference in the percentage of patients meeting McGeer symptom criteria for UTI between 2014 and 2015 (73.6% and 73.3% did not meet criteria, respectively). Seven of 14 patients meeting McGeer symptom criteria in 2014 did not meet microbiologic criteria. In 2015, 1 out of 8 patients meeting McGeer symptom criteria did not meet microbiologic criteria. Empiric antimicrobial selection was similar between 2014 and 2015, with ceftriaxone and ciprofloxacin being the most commonly prescribed.

    Conclusion:

    These results demonstrate that the number of antimicrobial orders with an indication of UTI decreased after provider education was implemented to reduce antimicrobial use for asymptomatic bacteriuria. A larger percentage of patients who did receive antimicrobials for UTI after this intervention had documented symptoms, however these symptoms were not any more consistent with McGeer criteria as those documented the previous year.

    Eric Myers, PharmD1, Chas Hoffmann, PharmD1, Emily Sydnor, MD, MHS2, Elizabeth Dodds Ashley, PharmD, MHS1, Mary Lourdes Brundige, PharmD3, Shashi Patel, PharmD4, Christopher Evans, PharmD1, Tina Khadem, PharmD5, Elizabeth Rightmier, PharmD5, Christina Felsen, MPH6, Mary Staicu, PharmD7 and Ghinwa Dumyati, MD, FSHEA1, (1)University of Rochester Medical Center, Rochester, NY, (2)University of Utah School of Medicine, Salt Lake City, UT, (3)Pharmacy, Rochester Regional Health, Rochester, NY, (4)Unity Health, Rochester, NY, (5)Highland Hospital, Rochester, NY, (6)Center for Community Health, University of Rochester Medical Center, Rochester, NY, (7)Rochester General Hospital, Rochester, NY

    Disclosures:

    E. Myers, None

    C. Hoffmann, None

    E. Sydnor, None

    E. Dodds Ashley, None

    M. L. Brundige, None

    S. Patel, None

    C. Evans, None

    T. Khadem, None

    E. Rightmier, None

    C. Felsen, None

    M. Staicu, None

    G. Dumyati, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.