ArticleIrish journal of medical science2025
The usefulness of previous urine culture and antibiogram results in guiding empiric antibiotic selection in the emergency department.
Article in Irish journal of medical science, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundUrinary tract infection (UTI) symptoms are common reasons for emergency department (ED) admissions. Selecting appropriate antibiotics is crucial in terms of both resistance prevention and clinical recovery.
aimsWe aimed to evaluate the usefulness of urine culture (UC) and antibiogram results in guiding empiric antibiotic selection and the compatibility of prescribed antibiotics at discharge with the ED UC and antibiogram results.
methodsPatients who presented to the ED over 1-year period and had prior UC results were enrolled in study retrospectively. Patients were excluded if their ED UCs were revealed as contaminated and showed no growth, or if their previous UCs had no growth despite positive ED UC results. Patients without an antibiogram in previous positive UCs were also excluded. Antibiotics prescribed at discharge were compared with the ED and previous culture/antibiogram findings to assess for appropriateness.
resultsEight thousand six hundred ninety-nine patients' charts were reviewed. Of the UCs, 36.2% were revealed as growth. When contamination results were excluded, growth ratio was decreased to 25.1%. The average age was 57 years. E. coli (51.3%) was the most frequently isolated pathogen. The most frequently prescribed antibiotic was cefixime. Empirically prescribed antibiotics consistency with the ED culture/antibiogram was 38%. If it had been written according to the previous culture/antibiogram result, it could have increased the consistency up to 64.8%.
conclusionUsing previous UC/antibiogram results to choose appropriate empiric antibiotics for UTIs may provide increased accuracy in selecting the appropriate empirical antibiotic for one in every four patients without new UC/antibiogram results.
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