MP71-20 REDUCING OVER-PRESCRIBING OF ANTIBIOTICS FOR SUSPECTED URINARY TRACT INFECTIONS IN A HEALTH SCIENCES CAMPUS STUDENT HEALTH SERVICE Article Swipe

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Elisabeth M. Sebesta , Anika March , Christopher Sayegh , Gen Li , Michelle Love , Gina M. Badalato , Marcy Ferdschneider , Kimberly L. Cooper ·

YOU? · · 2019 · Open Access · · DOI: https://doi.org/10.1097/01.ju.0000557132.04919.93

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Kidney & Bladder I (MP71)1 Apr 2019MP71-20 REDUCING OVER-PRESCRIBING OF ANTIBIOTICS FOR SUSPECTED URINARY TRACT INFECTIONS IN A HEALTH SCIENCES CAMPUS STUDENT HEALTH SERVICE Elisabeth M. Sebesta*, Anika March, Christopher Sayegh, Gen Li, Michelle Love, Gina M. Badalato, Marcy Ferdschneider, and Kimberly L. Cooper Elisabeth M. Sebesta*Elisabeth M. Sebesta* More articles by this author , Anika MarchAnika March More articles by this author , Christopher SayeghChristopher Sayegh More articles by this author , Gen LiGen Li More articles by this author , Michelle LoveMichelle Love More articles by this author , Gina M. BadalatoGina M. Badalato More articles by this author , Marcy FerdschneiderMarcy Ferdschneider More articles by this author , and Kimberly L. CooperKimberly L. Cooper More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000557132.04919.93AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Recommendations for management of women with suspected uncomplicated lower urinary tract infections (UTIs) include presumptive antibiotics (abx), with or without obtaining a urine culture (UCx). However, with increasing abx resistance, efforts to decrease abx usage are vital. We instituted this study at Columbia University Medical Center Student Health Services (CUMC-SHS) to determine if presumptive treatment of women with suspected uncomplicated UTIs is contributing to unnecessary abx usage. METHODS: We retrospectively reviewed all non-pregnant female patients presenting to CUMC-SHS with UTI symptoms from 12/2016-5/2017 who had UCx sent. Clinical information and presenting symptoms, in addition to office urine dip (Udip) and UCx results, were reviewed. Patients with upper urinary tract involvement or already on abx were excluded. Chi-squared and Fischer’s exact tests were performed to compare patients with a positive and negative UCx. RESULTS: A total of 67 patients were included for analysis. Presenting symptoms included dysuria (59/60, 98%), frequency (41/45, 91%), urgency (27/27, 100%), gross hematuria (17/33, 51%), and suprapubic pain (20/53, 38%). Many patients had symptoms for less than or equal to 24 hours before presentation (32/64, 50%). Office Udip was performed on 33/67 (49%) patients, the results of which were negative in 9%. Dips were positive for leukocytes (88%), blood (79%), and nitrites (18%). All patients were prescribed abx, most commonly nitrofurantoin (82%). Culture results were negative in 29/67 (43%). The most common pathogen on positive UCx was E. coli (84%). There were no significant differences in duration of symptoms, presenting symptoms, or Udip results between patients with a negative UCx and those with a positive UCx. CONCLUSIONS: Although current recommendations state standard of care for women with suspected uncomplicated UTI is presumptive abx, our study at a health sciences campus found a significant negative UCx rate, representing a cohort of patients who were exposed to abx unnecessarily. Additionally, we found no difference in presenting symptoms or Udip results to help distinguish patients with a positive UCx. It is now current practice at CUMC-SHS to recommend urinary analgesics and to wait for UCx results prior to initiating abx. We believe the findings of this study suggest a cohort in which abx usage can be reduced. Source of Funding: None New York, NY© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e1054-e1054 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Elisabeth M. Sebesta* More articles by this author Anika March More articles by this author Christopher Sayegh More articles by this author Gen Li More articles by this author Michelle Love More articles by this author Gina M. Badalato More articles by this author Marcy Ferdschneider More articles by this author Kimberly L. Cooper More articles by this author Expand All Advertisement PDF downloadLoading ...

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Medicine Urinary system Antibiotics Service (business) Family medicine Intensive care medicine Internal medicine Microbiology Biology Economics Economy

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Type: article
Language: en
Landing Page: https://doi.org/10.1097/01.ju.0000557132.04919.93
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Title: MP71-20 REDUCING OVER-PRESCRIBING OF ANTIBIOTICS FOR SUSPECTED URINARY TRACT INFECTIONS IN A HEALTH SCIENCES CAMPUS STUDENT HEALTH SERVICE

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Authors: Elisabeth M. Sebesta, Anika March, Christopher Sayegh, Gen Li, Michelle Love, Gina M. Badalato, Marcy Ferdschneider, Kimberly L. Cooper

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Concepts: Medicine, Urinary system, Antibiotics, Service (business), Family medicine, Intensive care medicine, Internal medicine, Microbiology, Biology, Economics, Economy

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abstract_inverted_index.24	320
abstract_inverted_index.67	283
abstract_inverted_index.E.	377
abstract_inverted_index.IN	26
abstract_inverted_index.It	466
abstract_inverted_index.L.	52, 123, 125, 592
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abstract_inverted_index.New	508
abstract_inverted_index.PDF	602
abstract_inverted_index.The	369
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abstract_inverted_index.Gina	45, 101, 576
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abstract_inverted_index.None	507
abstract_inverted_index.UCx.	278, 405, 465
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abstract_inverted_index.Udip	327, 392, 456
abstract_inverted_index.View	132
abstract_inverted_index.abx,	357, 422
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abstract_inverted_index.coli	378
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abstract_inverted_index.(49%)	332
abstract_inverted_index.29/67	367
abstract_inverted_index.33/67	331
abstract_inverted_index.38%).	309
abstract_inverted_index.50%).	325
abstract_inverted_index.51%),	304
abstract_inverted_index.91%),	297
abstract_inverted_index.98%),	294
abstract_inverted_index.Anika	37, 65, 548
abstract_inverted_index.LiGen	84
abstract_inverted_index.Love,	44
abstract_inverted_index.March	67, 549
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abstract_inverted_index.lower	155
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abstract_inverted_index.those	401
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abstract_inverted_index.(84%).	379
abstract_inverted_index.(88%),	347
abstract_inverted_index.(UCx).	171
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abstract_inverted_index.(Udip)	245
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abstract_inverted_index.100%),	300
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abstract_inverted_index.Author	134
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abstract_inverted_index.Cooper	53, 126, 593
abstract_inverted_index.Expand	599
abstract_inverted_index.HEALTH	28, 32
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abstract_inverted_index.March,	38
abstract_inverted_index.Office	326
abstract_inverted_index.Sayegh	76, 556
abstract_inverted_index.Source	504
abstract_inverted_index.Tract:	9
abstract_inverted_index.Volume	520
abstract_inverted_index.author	63, 72, 81, 90, 99, 110, 119, 131, 547, 554, 561, 568, 575, 583, 590, 598
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abstract_inverted_index.campus	429
abstract_inverted_index.cohort	438, 496
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abstract_inverted_index.female	220
abstract_inverted_index.health	427
abstract_inverted_index.office	242
abstract_inverted_index.usage.	213
abstract_inverted_index.vital.	183
abstract_inverted_index.(17/33,	303
abstract_inverted_index.(20/53,	308
abstract_inverted_index.(27/27,	299
abstract_inverted_index.(32/64,	324
abstract_inverted_index.(41/45,	296
abstract_inverted_index.(59/60,	293
abstract_inverted_index.(MP71)1	14
abstract_inverted_index.Bladder	12
abstract_inverted_index.Culture	362
abstract_inverted_index.Disease	5
abstract_inverted_index.Medical	191
abstract_inverted_index.SERVICE	33
abstract_inverted_index.STUDENT	31
abstract_inverted_index.Sayegh,	40
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abstract_inverted_index.culture	170
abstract_inverted_index.current	408, 469
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abstract_inverted_index.exposed	443
abstract_inverted_index.include	160
abstract_inverted_index.results	335, 363, 393, 457, 482
abstract_inverted_index.suggest	494
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abstract_inverted_index.urinary	156, 254, 475
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abstract_inverted_index.201Issue	521
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abstract_inverted_index.American	513, 532
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abstract_inverted_index.Funding:	506
abstract_inverted_index.However,	172
abstract_inverted_index.Kimberly	51, 122, 591
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abstract_inverted_index.Michelle	43, 92, 569
abstract_inverted_index.Patients	251
abstract_inverted_index.REDUCING	17
abstract_inverted_index.RESULTS:	279
abstract_inverted_index.SCIENCES	29
abstract_inverted_index.Sebesta*	58, 542
abstract_inverted_index.Services	195
abstract_inverted_index.ToolsAdd	136
abstract_inverted_index.addition	240
abstract_inverted_index.articles	60, 69, 78, 87, 96, 107, 116, 128, 544, 551, 558, 565, 572, 580, 587, 595
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abstract_inverted_index.included	286, 291
abstract_inverted_index.negative	277, 339, 365, 398, 433
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abstract_inverted_index.pathogen	372
abstract_inverted_index.patients	221, 272, 284, 311, 354, 395, 440, 461
abstract_inverted_index.positive	275, 344, 374, 404, 464
abstract_inverted_index.practice	470
abstract_inverted_index.reduced.	503
abstract_inverted_index.results,	248
abstract_inverted_index.reviewed	217
abstract_inverted_index.sciences	428
abstract_inverted_index.standard	411
abstract_inverted_index.symptoms	227, 290, 313, 454
abstract_inverted_index.2019Page:	524
abstract_inverted_index.Badalato,	47
abstract_inverted_index.Copyright	527
abstract_inverted_index.Education	516, 535
abstract_inverted_index.Elisabeth	34, 54, 540
abstract_inverted_index.Research,	518, 537
abstract_inverted_index.SUSPECTED	22
abstract_inverted_index.Sebesta*,	36
abstract_inverted_index.analysis.	288
abstract_inverted_index.determine	198
abstract_inverted_index.excluded.	262
abstract_inverted_index.frequency	295
abstract_inverted_index.hematuria	302
abstract_inverted_index.obtaining	167
abstract_inverted_index.patients,	333
abstract_inverted_index.performed	269, 329
abstract_inverted_index.recommend	474
abstract_inverted_index.reviewed.	250
abstract_inverted_index.suspected	153, 205, 417
abstract_inverted_index.symptoms,	238, 388, 390
abstract_inverted_index.treatment	201
abstract_inverted_index.(CUMC-SHS)	196
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abstract_inverted_index.MarchAnika	66
abstract_inverted_index.Presenting	289
abstract_inverted_index.Supplement	522
abstract_inverted_index.University	190
abstract_inverted_index.Urological	514, 533
abstract_inverted_index.analgesics	476
abstract_inverted_index.difference	451
abstract_inverted_index.increasing	174
abstract_inverted_index.infections	158
abstract_inverted_index.initiating	485
abstract_inverted_index.instituted	185
abstract_inverted_index.leukocytes	346
abstract_inverted_index.management	149
abstract_inverted_index.prescribed	356
abstract_inverted_index.presenting	222, 237, 389, 453
abstract_inverted_index.suprapubic	306
abstract_inverted_index.2019MP71-20	16
abstract_inverted_index.ANTIBIOTICS	20
abstract_inverted_index.Association	515, 534
abstract_inverted_index.Chi-squared	263
abstract_inverted_index.Christopher	39, 74, 555
abstract_inverted_index.Fischer’s	265
abstract_inverted_index.Information	539
abstract_inverted_index.OBJECTIVES:	146
abstract_inverted_index.antibiotics	162
abstract_inverted_index.differences	384
abstract_inverted_index.distinguish	460
abstract_inverted_index.e1054-e1054	525
abstract_inverted_index.information	235
abstract_inverted_index.involvement	256
abstract_inverted_index.presumptive	161, 200, 421
abstract_inverted_index.resistance,	176
abstract_inverted_index.significant	383, 432
abstract_inverted_index.unnecessary	211
abstract_inverted_index.BadalatoGina	103
abstract_inverted_index.CONCLUSIONS:	406
abstract_inverted_index.INTRODUCTION	144
abstract_inverted_index.LoveMichelle	93
abstract_inverted_index.contributing	209
abstract_inverted_index.non-pregnant	219
abstract_inverted_index.presentation	323
abstract_inverted_index.representing	436
abstract_inverted_index.Additionally,	447
abstract_inverted_index.Advertisement	526, 601
abstract_inverted_index.Ferdschneider	114, 585
abstract_inverted_index.Genitourinary	8
abstract_inverted_index.Permissions©	529
abstract_inverted_index.accessJournal	2
abstract_inverted_index.uncomplicated	154, 206, 418
abstract_inverted_index.12/2016-5/2017	229
abstract_inverted_index.CitationsTrack	139
abstract_inverted_index.CooperKimberly	124
abstract_inverted_index.Ferdschneider,	49
abstract_inverted_index.InTwitterEmail	142
abstract_inverted_index.nitrofurantoin	360
abstract_inverted_index.unnecessarily.	446
abstract_inverted_index.Recommendations	147
abstract_inverted_index.downloadLoading	603
abstract_inverted_index.recommendations	409
abstract_inverted_index.retrospectively	216
abstract_inverted_index.OVER-PRESCRIBING	18
abstract_inverted_index.Inc.MetricsAuthor	538
abstract_inverted_index.SayeghChristopher	75
abstract_inverted_index.Sebesta*Elisabeth	56
abstract_inverted_index.favoritesDownload	138
abstract_inverted_index.FerdschneiderMarcy	113
abstract_inverted_index.ShareFacebookLinked	141
abstract_inverted_index.CitationsPermissionsReprints	140
abstract_inverted_index.Inc.FiguresReferencesRelatedDetails	519
abstract_inverted_index.UrologyInfections/Inflammation/Cystic	4
abstract_inverted_index.Informationhttps://doi.org/10.1097/01.JU.0000557132.04919.93AboutPDF	135
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