Better Diagnostics Equals Fewer Unnecessary Antibiotic Prescriptions

By Jonathan Springston, Editor, Relias Media

Focusing on solid diagnostics led to a reduction in unnecessary antibiotic use among hospitalized patients treated for urinary tract infections (UTIs) who have asymptomatic bacteriuria (ASB), according to research presented on Oct. 21 during IDWeek 2022.

Investigators conducted a four-year study of nearly 50 hospitals that had instituted pay-for-performance metrics connected to unnecessary treatment of ASB. Over the study period, the percentage of patients treated with antibiotics for UTIs who had ASB dropped from 29% to 16.9%. The researchers reported diagnostic stewardship was the key reason for improvement.

ASB means bacteria are in urine, but the bacteria do not cause infection, nor does the patient exhibit symptoms. This condition is somewhat common; the authors noted about one-third of hospitalized patients treated for UTIs have ASB. However, they reported almost 80% of patients who have ASB are treated with antibiotics they do not need.

“Most efforts to combat antimicrobial resistance have focused on prescribing, but our research indicates that more progress can be made by looking further upstream — before a prescription is ever written,” said Valerie Vaughn, MD, MSc, director of hospital medicine research at the University of Utah. “Diagnostic stewardship is an important and effective part of overall responsible antibiotic use in healthcare settings.”

For more on this and related subjects, be sure to read the latest issues of Hospital Infection Control & Prevention, Infectious Disease Alert, and OB/GYN Clinical Alert.