Bradley J Langford1, Nick Daneman2, Christina Diong3, Alex Marchand-Austin3, Kwaku Adomako4, Arezou Saedi4, Kevin L Schwartz5, Jennie Johnstone6, Derek R MacFadden7, Larissa M Matukas8, Samir N Patel9, Gary Garber10, Kevin A Brown5. 1. Public Health Ontario, Hotel Dieu Shaver Health and Rehabilitation Centre, Ontario, Canada. Electronic address: Bradley.Langford@oahpp.ca. 2. Public Health Ontario, Sunnybrook Health Sciences Center, ICES, Institute of Health Policy Management and Evaluation, University of Toronto, Canada. 3. ICES, Ontario, Canada. 4. Public Health Ontario, Infection Prevention and Control, Canada. 5. Public Health Ontario, ICES, Dalla Lana School of Public Health, Canada. 6. Public Health Ontario, Sinai Health System, Dalla Lana School of Public Health, Canada. 7. Ottawa Hospital Research Institute, Canada. 8. Unity Health Toronto, University of Toronto, Department of Laboratory Medicine and Pathobiology, Canada. 9. Public Health Ontario, University of Toronto, Department of Laboratory Medicine and Pathobiology, Canada. 10. Public Health Ontario, University of Toronto, University of Ottawa, Ottawa Research Institute, Canada.
Abstract
OBJECTIVE: Selective reporting of antibiotic susceptibility test results may help guide appropriate antibiotic prescribing, particularly for urinary tract infections. Our objective was to describe laboratory urine culture susceptibility reporting practices and to estimate their impact on antibiotic prescribing in outpatients. METHODS: We examined all positive urine cultures with Escherichia coli, Klebsiella pneumoniae, or Proteus mirabilis associated with an antibiotic prescription among outpatients over 65 years of age in Ontario, Canada from 2014 through 2017. We evaluated antibiotic prescribing in the empirical window (1-3 days before culture result) and in the directed window (0-5 days after culture result). Unadjusted and adjusted odds ratios were reported to estimate the association between reporting and prescribing. RESULTS: In total 113 780 eligible urine cultures from 48 laboratories were included in the study cohort. Susceptibility reporting practices were highly variable between laboratories, with a range across antibiotics from norfloxacin (n = 5/48, 10.4% reporting) to nitrofurantoin (n = 40/48, 83.3% reporting). Reporting antibiotic susceptibility was associated with increased odds of prescribing that antibiotic in the directed window (aOR 2.98, 95%CI 2.07-4.28). At the laboratory level, the proportion of urine cultures reporting specific antibiotic susceptibility results was also associated with an increase in prescribing of that antibiotic in the empirical window (adjusted OR 1.23, 95%CI 1.13-1.33, per 25% increase in reporting). CONCLUSIONS: Laboratory reporting of antibiotic susceptibility results for urine cultures is associated with empirical and directed prescribing of the reported antibiotics. Laboratories can play an important role in guiding appropriate antibiotic selection for urinary indications. Crown
OBJECTIVE: Selective reporting of antibiotic susceptibility test results may help guide appropriate antibiotic prescribing, particularly for urinary tract infections. Our objective was to describe laboratory urine culture susceptibility reporting practices and to estimate their impact on antibiotic prescribing in outpatients. METHODS: We examined all positive urine cultures with Escherichia coli, Klebsiella pneumoniae, or Proteus mirabilis associated with an antibiotic prescription among outpatients over 65 years of age in Ontario, Canada from 2014 through 2017. We evaluated antibiotic prescribing in the empirical window (1-3 days before culture result) and in the directed window (0-5 days after culture result). Unadjusted and adjusted odds ratios were reported to estimate the association between reporting and prescribing. RESULTS: In total 113 780 eligible urine cultures from 48 laboratories were included in the study cohort. Susceptibility reporting practices were highly variable between laboratories, with a range across antibiotics from norfloxacin (n = 5/48, 10.4% reporting) to nitrofurantoin (n = 40/48, 83.3% reporting). Reporting antibiotic susceptibility was associated with increased odds of prescribing that antibiotic in the directed window (aOR 2.98, 95%CI 2.07-4.28). At the laboratory level, the proportion of urine cultures reporting specific antibiotic susceptibility results was also associated with an increase in prescribing of that antibiotic in the empirical window (adjusted OR 1.23, 95%CI 1.13-1.33, per 25% increase in reporting). CONCLUSIONS: Laboratory reporting of antibiotic susceptibility results for urine cultures is associated with empirical and directed prescribing of the reported antibiotics. Laboratories can play an important role in guiding appropriate antibiotic selection for urinary indications. Crown
Authors: Tat Ming Ng; Sock Hoon Tan; Shi Thong Heng; Hui Lin Tay; Min Yi Yap; Boon Hou Chua; Christine B Teng; David C Lye; Tau Hong Lee Journal: Antimicrob Resist Infect Control Date: 2021-02-03 Impact factor: 4.887
Authors: Asimina Safarika; James W Wacker; Konstantinos Katsaros; Nicky Solomonidi; George Giannikopoulos; Antigone Kotsaki; Ioannis M Koutelidakis; Sabrina M Coyle; Henry K Cheng; Oliver Liesenfeld; Timothy E Sweeney; Evangelos J Giamarellos-Bourboulis Journal: Intensive Care Med Exp Date: 2021-06-18