title: Overtreatment of asymptomatic bacteriuria: identifying targets for improvement.
abstract: Treatment of asymptomatic bacteriuria contributes to antimicrobial overuse in hospitalized patients. Indications for urine culture, treatment, and targets for improvement were evaluated in 153 patients. Drivers of antimicrobial overuse included fever with an alternative source, altered mental status, and leukocytosis, which led 435 excess days of antimicrobial therapy.
authors.affiliation: 1Department of Internal Medicine,University of Michigan,Ann Arbor,Michigan.
authors.forename: Sarah
authors.initials: S
authors.lastname: Hartley
authors.affiliation: 1Department of Internal Medicine,University of Michigan,Ann Arbor,Michigan.
authors.forename: Staci
authors.initials: S
authors.lastname: Valley
authors.affiliation: 3Patient Safety Enhancement Program and Hospital Outcomes Program of Excellence of the Ann Arbor Veterans Affairs Medical Center,Ann Arbor,Michigan.
authors.forename: Latoya
authors.initials: L
authors.lastname: Kuhn
authors.affiliation: 1Department of Internal Medicine,University of Michigan,Ann Arbor,Michigan.
authors.forename: Laraine L
authors.initials: LL
authors.lastname: Washer
authors.affiliation: 1Department of Internal Medicine,University of Michigan,Ann Arbor,Michigan.
authors.forename: Tejal
authors.initials: T
authors.lastname: Gandhi
authors.affiliation: 1Department of Internal Medicine,University of Michigan,Ann Arbor,Michigan.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Meddings
authors.affiliation: 1Department of Internal Medicine,University of Michigan,Ann Arbor,Michigan.
authors.forename: Carol
authors.initials: C
authors.lastname: Chenoweth
authors.affiliation: 2St. Joseph Mercy Hospital,Ann Arbor,Michigan.
authors.forename: Anurag N
authors.initials: AN
authors.lastname: Malani
authors.affiliation: 1Department of Internal Medicine,University of Michigan,Ann Arbor,Michigan.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Saint
authors.affiliation: 5Healthcare Associated Infection Prevention Programs in the Division of Healthcare Quality Promotion at the Centers for Disease Control and Prevention,Atlanta,Georgia.
authors.forename: Arjun
authors.initials: A
authors.lastname: Srinivasan
authors.affiliation: 1Department of Internal Medicine,University of Michigan,Ann Arbor,Michigan.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Flanders
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D058345:Asymptomatic Infections / Q000628:therapy*; D001437:Bacteriuria / Q000188:drug therapy*; D003428:Cross Infection / Q000188:drug therapy; D005260:Female; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control / Q000706:statistics & numerical data; D008297:Male; D000069342:Medical Overuse / Q000517:prevention & control / Q000706:statistics & numerical data*; D008875:Middle Aged; D058996:Quality Improvement; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents