ArticleNeurourology and urodynamics2025
Antibiotic Overprescription for "Urinary Tract Infections" Is Associated With Poor Diagnostic Stewardship and Low Adherence to Guidelines.
Article in Neurourology and urodynamics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Doctor-related Knowledge, Attitudes and Practices (KAP) factors influencing antibiotic prescribing for urinary tract infections in primary care in Singapore: a cross-sectional study.BMC primary care · 2026Article
- Evaluation of diagnostic accuracy using routine laboratory parameters.Bioinformation · 2026Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
purposeWhile urinary tract infections (UTIs) are thought to be common among women, as many as 65% of UTI diagnoses may be inaccurate. To identify strategies to improve antibiotic stewardship, we sought to determine the clinical and laboratory factors associated with overdiagnosis and overtreatment of UTIs.
methodsElectronic health records identified patients bearing an isolated diagnostic code for UTI within a single healthcare system during July 2019. Demographic, clinical, and microbial data were collected by manual chart review. Regression analyses were utilized to determine factors associated with guideline non-concordant UTI diagnosis and treatment utilizing R statistical software (version 4.3.1).
resultsIn patients diagnosed with UTI, 64% were treated with antibiotics despite only 28% having symptoms consistent with UTI diagnostic criteria. Of patients diagnosed with a UTI who were treated in an emergency room (ER) setting, 95% were given antibiotics compared with only 55% of patients in an outpatient setting. Even without any urinary symptoms, 95% of patients in the ER and 27% of patients in outpatient settings were treated with antibiotics. Patients who presented to the ER for non-localizing symptoms, such as mental status changes (MSC), were more likely to be diagnosed with UTI compared with those in an outpatient setting.
conclusionThe results of this study demonstrate that patients were frequently diagnosed with and treated for a UTI despite not meeting diagnostic criteria. This pattern of overdiagnosis leads to overtreatment, particularly in acute care settings, contributing to worsening antibiotic resistance in conjunction with incomplete evaluation of patients' primary complaints.
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