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April 19, 2024JAMA

Stewardship Prompts to Improve Antibiotic Selection for Urinary Tract Infection

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Authors

SGShruti K. GohilUniversity of California, IrvineESEdward SeptimusHarvard UniversityKKKen KleinmanIntermountain Healthcare

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Implication

Randomized trial demonstrates reduced extended-spectrum antibiotic use in adults hospitalized with urinary tract infection, highlighting the benefit of computerized stewardship prompts.

Key Points

  • Empiric extended-spectrum antibiotic prescribing decreased significantly following computerized provider order entry prompts for patients hospitalized with urinary tract infection.
  • Days of therapy dropped by 17.4% for extended-spectrum antibiotics, reflecting a rate ratio of 0.83 compared with routine stewardship across participating community hospitals.
  • Cluster-randomized trial across 59 community hospitals confirms stewardship prompts curb extended-spectrum antibiotics without altering intensive care transfer or length of stay.

Cite This Study

Gohil et al. (2024) studied this question.

synapsesocial.com/papers/68e6e657b6db64358766130chttps://doi.org/10.1001/jama.2024.6259
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Asymptomatic Bacteriuria Treatment Is Associated With a Higher Prevalence of Antibiotic Resistant Strains in Women With Urinary Tract Infections2015 · 149 citations
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  3. 3International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases2011 · 3,069 citations
  4. 4Empiric Piperacillin-Tazobactam versus Carbapenems in the Treatment of Bacteraemia Due to Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae2016 · 132 citations
  5. 5Distinct components of alert fatigue in physicians’ responses to a noninterruptive clinical decision support alert2022 · 28 citations