Journal article
Intravenous Antibiotic Susceptibility for Urinary Tract Infection Prior to Emergency Department Discharge
Hospital pharmacy (Philadelphia), Vol.56(5), pp.513-518
10/01/2021
DOI: 10.1177/0018578720925386
PMCID: PMC8554614
PMID: 34720154
Abstract
Background
Urinary tract infection (UTI) is a common infectious disease managed in the emergency department (ED). Patients may be initially treated with an intravenous (IV) antibiotic and subsequently discharged with an oral antibiotic regimen.
Objective
The purpose of this study was to determine whether the current Infectious Diseases Society of America guideline recommendation for an initial dose of long-acting IV antibiotic for treatment of UTI when the prevalence of fluoroquinolone resistance exceeds 10% improves the likelihood of providing in vitro susceptibility to the isolated uropathogen.
Methods
This was a retrospective study of patients in ED presenting between May 2009 and August 2018 who received treatment for UTI. The primary outcome was susceptibility of uropathogen to the IV antibiotic administered. Secondary outcomes included susceptibility to the oral antibiotic regimen prescribed at discharge, repeat health care visit within 30 days related to UTI follow-up, adverse events (AEs) associated with antibiotic use, and identification of risk factors associated with pathogen resistance.
Results
A total of 255 patients were included for analysis. Of these patients, 230 (90.2%) had pathogens susceptible to the administered IV antibiotic. The oral regimen susceptibility was 81.6% with 29 patients returning for UTI follow-up and 4 patients reporting AEs related to antibiotic use. Men and long-term care facility residents were more likely to have resistant uropathogens.
Conclusion
Administration of a long-acting IV antibiotic for treatment of UTI prior to ED discharge is recommended when the fluoroquinolone resistance rate exceeds 10% to improve in vitro susceptibility coverage.
Details
- Title: Subtitle
- Intravenous Antibiotic Susceptibility for Urinary Tract Infection Prior to Emergency Department Discharge
- Creators
- Stacey Rewitzer - University of IowaJosie Montgomery - University of Iowa Hospitals and ClinicsAnne Zepeski - University of IowaLexie Finer - University of IowaBrett A. Faine - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Hospital pharmacy (Philadelphia), Vol.56(5), pp.513-518
- DOI
- 10.1177/0018578720925386
- PMID
- 34720154
- PMCID
- PMC8554614
- NLM abbreviation
- Hosp Pharm
- ISSN
- 0018-5787
- eISSN
- 1945-1253
- Publisher
- SAGE Publications
- Language
- English
- Date published
- 10/01/2021
- Academic Unit
- Emergency Medicine; Pharmacy Practice and Science
- Record Identifier
- 9984544601902771
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