title: Male veterans with complicated urinary tract infections: Influence of a patient-centered antimicrobial stewardship program.
abstract: The influence of antimicrobial stewardship programs (ASPs) on outcomes in male veterans treated for complicated urinary tract infection has not been determined.
  
  
  
  This was a retrospective cohort study encompassing the study period January 1, 2005-October 31, 2014, which was conducted at a 150-bed Veterans Affairs Healthcare System facility in Buffalo, NY. Male veterans admitted for treatment of complicated urinary tract infection were identified using ICD-9-CM codes. Outcomes before and after implementation of a patient-centered ASP, including duration of antibiotic therapy, length of hospitalization, readmission within 30 days, and Clostridium difficile infection were compared. Interventions resulting from the ASP were categorized.
  
  
  
  Of the 1,268 patients screened, 241 met criteria for inclusion in the study (n = 118 and n = 123 in the pre-ASP and ASP group, respectively). Duration of antibiotic therapy was significantly shorter in the ASP group (10.32 days vs 11.96 days; P < .0001), as was length of hospitalization (5.76 days vs 6.76 days; P = .015). There was no difference in 30-day readmission. A total of 170 interventions were identified that resulted from the ASP (1.39 interventions per patient).
  
  
  
  ASPs may be useful to improve clinical outcomes in men with complicated urinary tract infection. Implementation of an ASP was associated with significant decreases in duration of antibiotic therapy and length of hospitalization, without adversely affecting 30-day readmission rates.
authors.affiliation: Veterans Affairs Western New York Healthcare System, Buffalo, NY.
authors.forename: James F
authors.initials: JF
authors.lastname: Carbo
authors.affiliation: Veterans Affairs Western New York Healthcare System, Buffalo, NY; Erie County Medical Center Corporation, Buffalo, NY.
authors.forename: Christine A
authors.initials: CA
authors.lastname: Ruh
authors.affiliation: Veterans Affairs Western New York Healthcare System, Buffalo, NY.
authors.forename: Kari E
authors.initials: KE
authors.lastname: Kurtzhalts
authors.affiliation: Erie County Medical Center Corporation, Buffalo, NY.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Ott
authors.affiliation: Veterans Affairs Western New York Healthcare System, Buffalo, NY; University at Buffalo School of Medicine, The State University of New York, Buffalo, NY.
authors.forename: John A
authors.initials: JA
authors.lastname: Sellick
authors.affiliation: Veterans Affairs Western New York Healthcare System, Buffalo, NY. Electronic address: kari.mergenhagen@va.gov.
authors.forename: Kari A
authors.initials: KA
authors.lastname: Mergenhagen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D004363:Drug Utilization / Q000592:standards*; D006801:Humans; D007902:Length of Stay; D008297:Male; D009518:New York; D010359:Patient Readmission; D012189:Retrospective Studies; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000188:drug therapy*; D014728:Veterans
chemical_list: D000890:Anti-Infective Agents
keywords: Antibacterial agents; Clinical outcomes; Hospitalization; Length of Stay; Patient care; Patient readmission