About My Health Careers Internship MedBlogs Contact us
Medindia LOGIN REGISTER
Advertisement

Novel Discovery Could Cut Unnecessary Testing for UTIs by Nearly Half

by Iswarya on February 22, 2019 at 10:59 AM
Font : A-A+

Novel Discovery Could Cut Unnecessary Testing for UTIs by Nearly Half

Novel change in the traditional system used by doctors can cut down on the cost of unnecessary tests for urinary tract infections, reports a new study. The findings of the study are published in the journal Infection Control and Hospital Epidemiology.

Tests to detect urinary tract infections (UTI) often are performed routinely in hospitals, even when patients don't have symptoms. Such testing "just to be safe" can return results that lead doctors to prescribe antibiotics when there's little to no evidence to warrant such treatment.

Advertisement


Now, new research indicates that making a simple change to the electronic system used by doctors to order urine tests can cut by nearly half the number of bacterial culture tests ordered without compromising the ability to identify people who need treatment for UTIs. The change encourages doctors to first look for signs of a UTI before testing a patient's urine for bacteria.

"Over-testing for UTIs drives up health-care costs and leads to unnecessary antibiotic use which spreads antibiotic resistance," said senior author and infectious diseases specialist David K. Warren, MD, a professor of medicine. "Ordering tests when the patient needs them is a good thing. But ordering tests when it's not indicated wastes resources and can subject patients to unnecessary treatment. We were able to reduce the number of tests ordered substantially without diminishing the quality of care at all, and at substantial cost savings."
Advertisement

Bacteria in a person's bladder can cause UTIs, which are characterized by burning or pain while urinating, frequent urges to urinate and fever. UTIs are treated with antibiotics. But some people often elderly people or those with diabetes - harbor harmless bacterial communities in their bladders that do not need to be treated with antibiotics.

Before ordering a urinalysis to check for bacteria in the urine, infectious disease specialists recommend that physicians look first for signs of bladder infection using a urine dipstick test. This test can detect inflammatory cells in the urine - signs of a problematic UTI that may require treatment with antibiotics. Discovering bacteria growing in the urine without knowing whether the patient has signs and symptoms of infection leaves physicians uncertain of whether the patient will benefit from antibiotic treatment.

"Doctors get stuck with a result they don't know how to interpret and often prescribe antibiotics because that seems like the safest path to take," said Warren, who is the medical director for infection prevention at Barnes-Jewish Hospital.

Warren, first author Satish Munigala, MD, a data analyst in infection prevention, and colleagues made two changes to encourage more informative urine testing among their colleagues at Barnes-Jewish Hospital. First, they sent an email to all clinicians explaining the rationale behind ordering a urine dipstick test for signs of infection before ordering a bacterial culture test. Then, they changed the electronic ordering system. They set the default to a urine dipstick test followed by a bacterial culture test, rather than a culture test alone, which had previously been the first option. Clinicians who wished to order a culture test alone could still do so, but they had to open an additional screen on their computers.

The researchers compared all urine culture tests ordered at Barnes-Jewish Hospital in the 15 months before the intervention, staged in April 2016, to the 15 months after. Before the intervention, doctors ordered 15,746 urine cultures or 38 orders per 1,000 patient-days. After, they ordered 45 percent fewer: 8,823 total, or 21 orders per 1,000 patient-days.

In particular, the number of urine cultures from people with catheters - who are at high risk of UTIs - dropped from 7.8 to 1.9 per 1000 patient-days while the number of catheter-associated UTIs did not change at all. There were 125 diagnosed catheter-associated UTIs in each time period.

"Everyone always worries that by ordering fewer urine cultures we might miss some UTIs, but we showed that we did not," Warren said. Since it costs about $15 to perform a urine culture, the intervention saved approximately $104,000 in laboratory costs alone over the 15-month period. The researchers were unable to obtain pharmacy records to determine whether more careful testing decreased antibiotic prescriptions, but previous studies have shown that minimizing unwarranted testing does reduce antibiotic overuse.

Source: Eurekalert
Advertisement

Advertisement
News A-Z
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
News Category
What's New on Medindia
World Heart Day 2021 -
Are Black Foods the New Superfood?
Ten Fruits for Diabetics
View all

Medindia Newsletters Subscribe to our Free Newsletters!
Terms & Conditions and Privacy Policy.

More News on:
Urinary Tract Infection During Pregnancy 

Recommended Reading
Does Cranberry Juice Really Help Prevent Urinary Tract Infections?
Is the age-old belief that cranberry juice prevents urinary tract infection (UTI) true? What does .....
Treat Urinary Tract Infections Without Antibiotics
Treating urinary tract infections (UTIs) without the use of antibiotics may be in the horizon with ....
Critical Bacterial Protein Linked to Chronic Urinary Tract Infections (UTIs) Identified
New protein that may be responsible for chronic and severe urinary tract infections by E. coli has ....
Guidelines for the Treatment of Uncomplicated Urinary Tract Infections in Women
A recent article reviews guidelines for the treatment of uncomplicated urinary tract infections ......
Urinary Tract Infection During Pregnancy
Urinary tract infections are caused mainly by E.coli and can occur during pregnancy. If not treate...

Disclaimer - All information and content on this site are for information and educational purposes only. The information should not be used for either diagnosis or treatment or both for any health related problem or disease. Always seek the advice of a qualified physician for medical diagnosis and treatment. Full Disclaimer

© All Rights Reserved 1997 - 2021

This site uses cookies to deliver our services. By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use