Approved Hospital Formulary
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Approved Hospital Formulary
4/13/22 mb Update on Urine Culture Comment - ADULTS
April 13, 2022
From: "Madeline Belk" <madeline.belk@hhsys.org>
To: "Pharmacists" <grp_allpharm@hhsys.org>
Sent: Wednesday, April 13, 2022 8:01:56 AM
Subject: Update on Urine Culture Comment - ADULTS
PDCA on ASB project
Good morning, pharmacists -
If you will recall, a microbiology comment nudge was added to adult urine cultures growing < 100 K CFU of bacteria to help minimize the treatment of asymptomatic bacteriuria (ASB). The comment read “Assess for UTI symptoms with urine cultures growing < 100 K CFU. Antibiotic treatment is not recommended in patients with ASB outside of pregnancy & urologic procedures”. Results from this project showed a significant decrease in the number of patients with antibiotics continued beyond 72 hours (55% to 38%) after the urine culture comment was implemented, significant decrease in antibiotics continued beyond 48 hours (58% to 43%), significant decrease in antibiotics prescribed at discharge (34% to 20%), and a significant decrease in antibiotic days of therapy (median of 4 days versus 1 day).
Due to the success of this intervention, the ID Subcommittee and Pharmacy and Therapeutics Committee has agreed to implement the urine culture on all ADULT urine cultures despite CFU count since symptoms should be present in patients who are being treated for UTIs (unless one of the exclusions mentioned in the comment are met). The updated comment will read as:
"Assess for urinary tract infection symptoms in all ADULT patients with positive urine cultures irrespective of colony forming unit count. Antibiotic treatment is not recommended in patients with asymptomatic bacteriuria outside of pregnancy and urologic procedures."
For more information, please see the attached PDCA.