Algorithm Cuts Antibiotic Use for Suspected UTI

Study in nursing home patients suggests algorithm safe to use

FRIDAY, Sept. 30 (HealthDay News) -- The use of an algorithm by doctors and nurses can reduce antibiotic use for treatment of suspected urinary tract infections (UTIs) in nursing home residents, according to a report in the Sept. 24 issue of the British Medical Journal. The use of an algorithm did not increase the risk of mortality or hospitalization.

Mark Loeb, M.D., of McMaster University in Ontario, Canada, and colleagues conducted a study involving 24 nursing homes in Ontario and Idaho, including 4,217 residents. Half of the nursing homes used a diagnostic and treatment algorithm to determine if antimicrobials should be used for a suspected UTI, and half treated patients with the usual care.

The algorithm contained two parts, the first of which assessed the presence of fever, catheterization and various symptoms and determined if urinary cultures should be ordered. The second part required assessment of various symptoms following receipt of urinary culture results and determined if antibiotics should be administered.

The rate of antibiotic use was 1.59 treatments per 1,000 resident days in the usual treatment group and 1.17 with the algorithm. Mortality and hospitalizations were similar in both groups.

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