title: Preventing the inappropriate treatment of asymptomatic bacteriuria at a community teaching hospital.
abstract: The goal of this study was to assess the overtreatment of asymptomatic bacteriuria (ASB) in hospitalized patients, calculate the total costs of inappropriate treatment, and determine if a multi-faceted educational intervention was effective in reducing the overtreatment of ASB in a resource-limited community hospital. The study encompassed three phases: a retrospective pre-intervention assessment of the baseline cost and treatment of ASB, the implementation of a multi-faceted educational intervention, and a prospective post-intervention assessment of the efficacy of the intervention. A positive urine culture was defined by bacterial counts ≥10(5) cfu/mL. In the pre-intervention group, 64 (83%) of 109 patients were asymptomatic: 30 (47%) were treated. In the post-intervention group, 13 (17%) of 55 patients were asymptomatic: 2 (15%) were treated, (p=0.04). Fewer urine cultures were collected during the post-intervention period than the pre-intervention period (3,127 and 3,419, respectively) (p<0.001). The total cost of inappropriately treating ASB in the pre-intervention group was $1200 compared to $600 in the post-intervention group. The results demonstrated a significant decrease in the inappropriate treatment of ASB and the associated costs.
authors.affiliation: Department of Internal Medicine, Lutheran Medical Center, New York, NY, USA.
authors.forename: Farhana
authors.initials: F
authors.lastname: Chowdhury
authors.forename: Kumkum
authors.initials: K
authors.lastname: Sarkar
authors.forename: Angela
authors.initials: A
authors.lastname: Branche
authors.forename: Juliette
authors.initials: J
authors.lastname: Kim
authors.forename: Philip
authors.initials: P
authors.lastname: Dwek
authors.forename: Angelica
authors.initials: A
authors.lastname: Nangit
authors.forename: David
authors.initials: D
authors.lastname: Tompkins
authors.forename: Ernest
authors.initials: E
authors.lastname: Visconti
keywords: disease management; economics; guideline adherence; practice guidelines as topic; prevention and control; trends; urinary tract infections