Data from University of Maryland Provide New Insights into Antimicrobials (Impact of Changes in Urine Culture Ordering Practice on Antimicrobial Utilization in Intensive Care Units at an Academic Medical Center)
By a News Reporter-Staff News Editor at Drug Week Research findings on Drugs and Therapies are discussed in a new report. According to news reporting from Baltimore, Maryland, by NewsRx journalists, research stated, "To assess antimicrobial utilization before and after a change in urine culture ordering practice in adult intensive care units (ICUs) whereby urine cultures were only performed when pyuria was detected. Quasi-experimental study SETTING."
The news correspondents obtained a quote from the research from the University of Maryland, "A 700-bed academic medical center PATIENTS. Patients admitted to any adult ICU METHODS. Aggregate data for all adult ICUs were obtained for population-level antimicrobial use (days of therapy [ DOT]), urine cultures performed, and bacteriuria, all measured per 1,000 patient days before the intervention (January-December 2012) and after the intervention (January-December 2013). These data were compared using interrupted time series negative binomial regression. Randomly selected patient charts from the population of adult ICU patients with orders for urine culture in the presence of indwelling or recently removed urinary catheters were reviewed for demographic, clinical, and antimicrobial use characteristics, and pre- and post-intervention data were compared. Statistically significant reductions were observed in aggregate monthly rates of urine cultures performed and bacteriuria detected but not in DOT. At the patient level, compared with the pre-intervention group (n = 250), in the post-intervention group (n=250), fewer patients started a new antimicrobial therapy based on urine culture results (23% vs 41%, P=.002), but no difference in the mean total DOT was observed. A change in urine-culture ordering practice was associated with a decrease in the percentage of patients starting a new antimicrobial therapy based on the index urine-culture order but not in total duration of antimicrobial use in adult ICUs."
According to the news reporters, the research concluded: "Other drivers of antimicrobial use in ICU patients need to be evaluated by antimicrobial stewardship teams."
For more information on this research see: Impact of Changes in Urine Culture Ordering Practice on Antimicrobial Utilization in Intensive Care Units at an Academic Medical Center. Infection Control and Hospital Epidemiology, 2016;37(4):448-454. Infection Control and Hospital Epidemiology can be contacted at: Cambridge Univ Press, 32 Avenue Of The Americas, New York, NY 10013-2473, USA. (University of Chicago Press - press.uchicago.edu; Infection Control and Hospital Epidemiology - /ucp/journals/journal/iche.html)
Our news journalists report that additional information may be obtained by contacting M. Sarg, University of Maryland, Sch Med, Dept. of Epidemiol & Public Hlth, Baltimore, MD 21201, United States. Additional authors for this research include G.E. Waldrop, M.A. Beier, E.L. Heil, K.A. Thom, M.A. Preas, J.K. Johnson, A.D. Harris and S. Leekha (see also Drugs and Therapies).
Keywords for this news article include: Antimicrobials, Maryland, Hospital, Baltimore, United States, Critical Care, Intensive Care, Drugs and Therapies, North and Central America
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