Effect of microbiology comment nudging on antibiotic use in asymptomatic bacteriuria: A before-and-after quasi-experimental study

Link to article at PubMed

Infect Control Hosp Epidemiol. 2023 Mar 16:1-5. doi: 10.1017/ice.2022.272. Online ahead of print.


OBJECTIVE: To describe the effect of a microbiology comment nudge on antibiotic use for asymptomatic bacteriuria (ASB).

DESIGN: Single-center, before-and-after, quasi-experimental study.

SETTING: Community-based, public, not-for-profit teaching hospital in the southeastern United States.

PARTICIPANTS: Adult inpatients with a positive urine culture and the absence of urinary tract infection signs and symptoms.

INTERVENTION: Implementation of a microbiology comment nudge on urine cultures.

RESULTS: In total, 204 patients were included in the study. Antibiotics were less likely to be continued beyond 72 hours in the postimplementation group: 57 (55%) of 104 versus 38 (38%) of 100 (P = .016). They were less likely to have antibiotics continued beyond 48 hours: 60 (58%) of 104 versus 43 (43%) of 100 (P = .036). They were also less likely to have antibiotics prescribed at discharge 35 (34%) of 104 versus 20 (20%) of 100 (P = .028). In addition, they had fewer total antibiotic days of therapy: 4 (IQR, 1-6) versus 1 (IQR, 0-6) (P = .022).

CONCLUSION: Microbiology comment nudging may contribute to less antibiotic utilization in patients with ASB.

PMID:36924157 | DOI:10.1017/ice.2022.272

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