title: Evaluation of urinalyses ordered for diagnosis of urinary tract infections at an inpatient psychiatric hospital.
abstract: OBJECTIVE
  A retrospective study was conducted to assess the diagnosis and treatment of urinary tract infections (UTIs) using urinalyses (UA)s at a psychiatric hospital.
  
  
  METHODS
  Patients admitted between July 2010 and June 2011 receiving at least one UA during inpatient psychiatric hospitalization were included. Pregnant patients and those with a UA receiving antibiotic treatment in the emergency department were excluded. The primary objective of the study was to characterize and assess the appropriateness of UAs ordered for the diagnosis of UTIs. Secondary objectives included analyzing frequency of cultures obtained, appropriateness of empiric antibiotics, and de-escalation of therapy if warranted.
  
  
  RESULTS
  Thirty-nine percent (n = 891/2292) of patients admitted received a UA at least once during their hospitalization. Of 203 patients further evaluated, 78% were asymptomatic, 11% were older than 65 years of age with altered mental status (AMS) or dementia, and 11% had typical UTI symptoms. Thirty-one patients were given antibiotics for a UTI during their stay, with a majority of those being asymptomatic (n = 19/31).
  
  
  CONCLUSIONS
  A significant proportion of UAs ordered at a psychiatric hospital were inappropriate. When patients were treated, empiric antibiotic selection and length of treatment were appropriate in most instances.
authors: Brittany R
authors: BR
authors: Cogdill
authors: Clint A
authors: CA
authors: Ross
authors: John M
authors: JM
authors: Hurst
authors: Kelli L
authors: KL
authors: Garrison
authors: Shannon J
authors: SJ
authors: Drayton
authors: Christopher S
authors: CS
authors: Wisniewski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001431:Bacteriological Techniques / Q000706:statistics & numerical data; D003114:Colony-Forming Units Assay / Q000706:statistics & numerical data; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004334:Drug Administration Schedule; D005260:Female; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013022:South Carolina; D019564:Unnecessary Procedures / Q000706:statistics & numerical data*; D016482:Urinalysis / Q000706:statistics & numerical data*; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D014600:Utilization Review / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents