ArticlePloS one2015
A Controlled Quasi-Experimental Study of an Educational Intervention to Reduce the Unnecessary Use of Antimicrobials For Asymptomatic Bacteriuria.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.
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Who cites it
26 citing papers in PubMed, 3 syntheses or guidelines pooled it, 51 citations in OpenAlex.
- A systematic review and meta-analysis to identify behavioural content and active ingredients of antimicrobial stewardship education and training interventions in hospital-based care settings.Antimicrobial resistance and infection control · 2025Pooled it
- A Systematic Review of Antimicrobial Stewardship Interventions to Improve Management of Bacteriuria in Hospitalized Adults.The Annals of pharmacotherapy · 2023Pooled it
- Inappropriate use of clinical practices in Canada: a systematic review.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2022Pooled it
- Targeting Overtreatment of Asymptomatic Bacteriuria in the Emergency Department: Results from a Quasi-Experimental Clinical Pharmacist-Led Program Based on Education and Audit.Antibiotics (Basel, Switzerland) · 2025Article
- Pyuria in hospitalized general medical patients without urinary tract infection.F1000Research · 2024Article
- Management of Asymptomatic Bacteriuria and Urinary Tract Infections in Patients With Neurogenic Bladder and Factors Associated With Inappropriate Diagnosis and Treatment.Archives of physical medicine and rehabilitation · 2024Article
- Implementing diagnostic stewardship to improve diagnosis of urinary tract infections across three medical centers: A qualitative assessment.Infection control and hospital epidemiology · 2023Article
- Implementation of an asymptomatic bacteriuria assessment protocol for patients discharged from the emergency department.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Strategies for de-implementation of low-value care-a scoping review.Implementation science : IS · 2022Article
- Analysis of an Antibiotic Stewardship Program for Asymptomatic Bacteriuria in the Veterans Affairs Health Care System.JAMA network open · 2022Article
- Sustained impact of an antibiotic stewardship initiative targeting asymptomatic bacteriuria and pyuria in the emergency department.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2022Article
- The Five Ds of Outpatient Antibiotic Stewardship for Urinary Tract Infections.Clinical microbiology reviews · 2021Review
- Treatment of Asymptomatic Bacteriuria after Implementation of an Inpatient Urine Culture Algorithm in the Electronic Medical Record.Pharmacy (Basel, Switzerland) · 2021Article
- Article
- Determinants for the use and de-implementation of low-value care in health care: a scoping review.Implementation science communications · 2021Article
- Why do they do it? A grounded theory study of the use of low-value care among primary health care physicians.Implementation science : IS · 2020Article
- Targeting Asymptomatic Bacteriuria in Antimicrobial Stewardship: the Role of the Microbiology Laboratory.Journal of clinical microbiology · 2020Review
- Advances and Challenges in the Diagnosis and Treatment of Urinary Tract Infections: the Need for Diagnostic Stewardship.Current infectious disease reports · 2019Review
- Effect of changing urine testing orderables and clinician order sets on inpatient urine culture testing: Analysis from a large academic medical center.Infection control and hospital epidemiology · 2019Article
- Gaps in communication between different staff groups and older adult patients foster unnecessary antibiotic prescribing for urinary tract infections in hospitals: a qualitative translation approach.Antimicrobial resistance and infection control · 2019Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAsymptomatic bacteriuria (ABU) should only be treated in cases of pregnancy or in-patients undergoing urologic procedures; however, unnecessary treatment of ABU is common in clinical practice.
objectiveTo identify risk factors for unnecessary treatment and to assess the impact of an educational intervention focused on these risk factors on treatment of ABU.
designQuasi-experimental study with a control group.
settingTwo tertiary teaching adult care hospitals.
participantsConsecutive patients with positive urine cultures between January 30th and April 17th, 2012 (baseline) and January 30th and April 30th, 2013 (intervention).
interventionIn January 2013, a multifaceted educational intervention based on risk factors identified during the baseline period was provided to medical residents (monthly) on one clinical teaching unit (CTU) at one hospital site, with the CTU of the other hospital serving as the control.
resultsDuring the baseline period, 160/341 (46.9%) positive urine cultures were obtained from asymptomatic patients at the two hospitals, and 94/160 (58.8%) were inappropriately treated with antibiotics. Risk factors for inappropriate use included: female gender (OR 2.1, 95% CI 1.1-4.3), absence of a catheter (OR 2.5, 1.2-5), bacteriuria versus candiduria (OR 10.6, 3.8-29.4), pyuria (OR 2.0, 1.1-3.8), and positive nitrites (OR 2.2, 1.1-4.5). In 2013, only 2/24 (8%) of ABU patients were inappropriately treated on the intervention CTU as compared to 14/29 (52%) on the control CTU (OR 0.10; 95% CI 0.02-0.49). A reduction was also observed as compared to baseline on the intervention CTU (OR 0.1, 0.02-0.7) with no significant change noted on the control CTU (OR 0.47, 0.13-1.7).
conclusionsA multifaceted educational intervention geared towards medical residents with a focus on identified risk factors for inappropriate management of ABU was effective in reducing unnecessary antibiotic use.
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