P-1740. Impact of a System Wide Antimicrobial Stewardship Intervention Bundle to Improve Guideline Directed Antibiotics for Urinary Tract Infections
Abstract
Abstract Background Urinary tract infections (UTIs) are one of the common reasons for antibiotic use across healthcare settings. Across an eleven-hospital system, common urinary pathogens (E. coli, Proteus species, and Klebsiella species) had greater than 80% coverage with cefazolin, which was within 0-8% of ceftriaxone coverage based on the local antibiograms. With increased risk of C. difficile infection and resistance development seen with ceftriaxone, cefazolin was promoted as first line for empiric UTI coverage.Table 1: Outcomes Methods An interrupted time series analysis was performed comparing a pre-intervention group to two phases of stewardship intervention (figure 1). The first intervention included an updated guideline, education, and pharmacist intervention upon order verification recommending guideline directed therapy. Guideline directed options and guideline non-compliant options are highlighted on green and red respectively, on figure 3. The second intervention was cascade reporting (figure 2) for urine culture Enterobacterales susceptibility, which was implemented across sites between 9/2023-1/2024. A generalized linear model with Poisson link was fit to the data. Compliant orders were regressed vs. the denominator of all UTI orders. Multiple models were considered, and the final model selection was based on likelihood ratio testing and the rule of parsimony.Figure 1: Interrupted Time-Series White = pre-intervention; light gray = intervention 1; dark gray =…
Read the paper
Related studies
- Association of lower urinary tract symptoms and OAB severity with quality of life and mental health in China, Taiwan and South Korea: results from a cross-sectional, population-based study
- Ten-Day Quadruple Therapy Comprising Low-Dose Rabeprazole, Bismuth, Amoxicillin, and Tetracycline Is an Effective and Safe First-Line Treatment for Helicobacter pylori Infection in a Population with High Antibiotic Resistance: a Prospective, Multicenter, Randomized, Parallel-Controlled Clinical Trial in China
- The Role of the NLR and PLR in Urinary Tract Infection
- Threat of Antimicrobial Resistance among Pilgrims with Infectious Diseases during Hajj: Lessons Learnt from COVID-19 Pandemic
- Leclercia adecarboxylata urinary tract infection in a patient with bladder cancer and recurrent hematuria
- A Case Series of Staphylococcus lugdunensis Infection in Cancer Patients at an Academic Cancer Institute in the United States
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.