title: Impact of antibiotic choices made in the emergency department on appropriateness of antibiotic treatment of urinary tract infections in hospitalized patients.
abstract: BACKGROUND
  Overuse of antibiotics to treat urinary tract infections (UTIs) is common in hospitalized patients and may begin in the emergency department (ED).
  
  
  METHODS
  For a 4-week period we reviewed medical records of all patients admitted to the hospital who initiated treatment for a UTI in the ED.
  
  
  RESULTS
  According to study criteria, initiation of antibiotics was inappropriate for 55 of 94 patients (59% [95% confidence interval {CI}, 48%-69%]), and continuation after admission was inappropriate for 54 of 80 patients (68% [95% CI, 57%-78%]).
  
  
  CONCLUSIONS
  Failure to reevaluate the need for antibiotics initiated in the ED to treat UTIs may lead to overuse of antibiotics in hospitalized patients.
authors.affiliation: Collaborative Inpatient Medical Service, Department of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland.
authors.forename: Dmitry
authors.initials: D
authors.lastname: Kiyatkin
authors.affiliation: Department of Emergency Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland.
authors.forename: Edward
authors.initials: E
authors.lastname: Bessman
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland.
authors.forename: Robin
authors.initials: R
authors.lastname: McKenzie
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D008297:Male; D012189:Retrospective Studies; D014552:Urinary Tract Infections / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents