Evidence map›Paper›PMID 39371441›Full record

ArticleAntimicrobial stewardship & healthcare epidemiology : ASHE2024

Effect of automated identification of antimicrobial stewardship opportunities for suspected urinary tract infections.

Connor R Deri, Rebekah W Moehring, Nicholas A Turner, Justin Spivey, Sonali D Advani, Rebekah H Wrenn, Michael E Yarrington

Abstract read
In one paragraph

Article in Antimicrobial stewardship & healthcare epidemiology : ASHE, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Connor R DeriDepartment of Pharmacy, Duke University Medical Center, Durham, NC, USA.ORCID https://orcid.org/0000-0002-9626-1197
Rebekah W MoehringDuke Center for Antimicrobial Stewardship and Infection Prevention, Durham, NC, USA.
Nicholas A TurnerDuke Center for Antimicrobial Stewardship and Infection Prevention, Durham, NC, USA.ORCID https://orcid.org/0000-0003-0650-4894
Justin SpiveyDepartment of Pharmacy, McLeod Health Seacoast, Little River, SC, USA.
Sonali D AdvaniDuke Center for Antimicrobial Stewardship and Infection Prevention, Durham, NC, USA.ORCID https://orcid.org/0000-0001-5162-6482
Rebekah H WrennDepartment of Pharmacy, Duke University Medical Center, Durham, NC, USA.
Michael E YarringtonDuke Center for Antimicrobial Stewardship and Infection Prevention, Durham, NC, USA.ORCID https://orcid.org/0000-0003-3186-1519

Funding

Duke KURe ProgramK12DK100024 · NIDDK · DUKE UNIVERSITY · PI Cindy Amundsen · 2013 to 2026
$8.4M
NIDDK NIH HHS K12 DK100024
6 · The paper itself

Abstract

Objective: We aimed to determine whether automated identification of antibiotic targeting suspected urinary tract infection (UTI) shortened the time to antimicrobial stewardship (AS) intervention. Design: Retrospective before-and-after study. Setting: Tertiary and quaternary care academic medical center. Patients: Emergency department (ED) or admitted adult patients meeting best practice alert (BPA) criteria during pre- and post-BPA periods. Methods: We developed a BPA to alert AS pharmacists of potential ASB triggered by the following criteria: ED or admitted status, antibiotic order with genitourinary indication, and a preceding urinalysis with ≤ 10 WBC/hpf. We evaluated the median time from antibiotic order to AS intervention and overall percent of UTI-related interventions among patients in pre-BPA (01/2020-12/2020) and post-BPA (04/15/2021-04/30/2022) periods. Results: 774 antibiotic orders met inclusion criteria: 355 in the pre- and 419 in the post-BPA group. 43 (35 UTI-related) pre-BPA and 117 (94 UTI-related) post-BPA interventions were documented. The median time to intervention was 28 hours (IQR 18-65) in the pre-BPA group compared to 16 hours (IQR 2-34) in the post-BPA group ( Conclusions: Automated identification of antibiotics targeting UTI without pyuria on urinalysis reduced the time to stewardship intervention and increased the rate of UTI-specific interventions. Clinical decision support aided in the efficiency of AS review and syndrome-targeted impact, but cases still required AS clinical review.

Identifiers

PMID39371441
PMCPMC11450662

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.