High Susceptibility Antibiotics Reduce Readmission Rates for Urinary Tract Infections

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Creating a community source specific urinary pathogen antibiogram to base the empiric antibacterial therapy for ED patients with UTI may be useful in reduction of 30 day readmission rates.
Creating a community source specific urinary pathogen antibiogram to base the empiric antibacterial therapy for ED patients with UTI may be useful in reduction of 30 day readmission rates.
This article is part of Infectious Disease Advisor's coverage of IDWeek 2018, taking place in San Francisco, CA. Our on-site staff will be reporting on the latest breaking research and clinical advances in infectious diseases. Check back regularly for highlights from IDWeek 2018.

SAN FRANCISCO — The use of a moderate to low susceptibility antibiotic to treat a urinary tract infection (UTI) may result in a 1.74-fold increase in the odds of an emergency department readmission within 30 days for another UTI, according to a study presented at the IDWeek in San Francisco, CA, October 3-7, 2018.

This study evaluated the creation of an antimicrobial stewardship program to define the community-specific urine antibiogram and categorize antibiotic therapy into high susceptible antibiotics (≥90%) and moderate to low susceptible antibiotics (<90%). Researchers retrospectively analyzed 594 patients who tested positive on a urine culture in the emergency department. Information was collected on the type of urine pathogen present, whether the patient received a high susceptibility or moderate to low susceptibility antibiotic, and if the patient was readmitted for another UTI 30 days after discharge.

Patients who received moderate to low susceptibility antibiotics (44.9%) had a higher 30-day readmission rate when compared with patients who received high susceptibility antibiotics (14.2% vs 7.95%, respectively; P =.014). The adjusted odds ratio for readmission was 1.74 (95% CI, 1.01-2.99; P =.047).

The researchers concluded that creating an antimicrobial stewardship program with a community specific urine antibiogram “may be a useful tool in reduction of 30 day readmission rates” in patients with UTIs who are treated in the emergency department.

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Reference

Lee S, Jones S, Casapao AM. Empiric antibiotic therapy and readmission rate in patients with urinary tract infection. Poster presented at: 2018 IDWeek Annual Meeting; Oct. 3-7, 2018; San Francisco, CA. Abstract 46.

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