title: Lessons from audit and feedback of hospitalized patients with bacteriuria.
abstract: We sought to prevent the initiation of antimicrobial therapy for asymptomatic bacteriuria (ASB) by providing audit and feedback of newly reported positive urine cultures to test whether this could empower providers to leave ASB untreated. Despite success in providing feedback before antibiotics could be initiated in most cases, these recommendations only reduced treatment duration, without affecting antibiotic initiation. This study highlights the limitations of educational initiatives in overcoming engrained beliefs about bacteriuria even when advice is provided in real time.
authors.affiliation: Division of Infectious Diseases, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, ON, Canada. Electronic address: jerome.leis@sunnybrook.ca.
authors.forename: Jerome A
authors.initials: JA
authors.lastname: Leis
authors.affiliation: Department of Pharmacy, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
authors.forename: Lesley
authors.initials: L
authors.lastname: Palmay
authors.affiliation: Department of Pharmacy, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
authors.forename: Marion
authors.initials: M
authors.lastname: Elligsen
authors.affiliation: Division of Infectious Diseases, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; Department of Pharmacy, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
authors.forename: Sandra A N
authors.initials: SA
authors.lastname: Walker
authors.affiliation: Department of Pharmacy, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
authors.forename: Colin
authors.initials: C
authors.lastname: Lee
authors.affiliation: Division of Infectious Diseases, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, ON, Canada.
authors.forename: Nick
authors.initials: N
authors.lastname: Daneman
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D058070:Asymptomatic Diseases / Q000628:therapy*; D001437:Bacteriuria / Q000175:diagnosis* / Q000188:drug therapy*; D004363:Drug Utilization; D005260:Female; D006302:Health Services Research; D006801:Humans; D008297:Male; D014556:Urine / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Asymptomatic bacteriuria; Quality improvement; Urine culture