Assessment of Prescription Practice and Microorganism Resistance to Antibiotics: Implications for Management of Uncomplicated Urinary Tract Infections

2.50
Hdl Handle:
http://hdl.handle.net/10755/148209
Type:
Presentation
Title:
Assessment of Prescription Practice and Microorganism Resistance to Antibiotics: Implications for Management of Uncomplicated Urinary Tract Infections
Abstract:
Assessment of Prescription Practice and Microorganism Resistance to Antibiotics: Implications for Management of Uncomplicated Urinary Tract Infections
Conference Sponsor:Sigma Theta Tau International
Conference Year:2003
Author:Grossman, Sheila Carey, APRN, FNP, PhD
P.I. Institution Name:Fairfield University
Title:Professor & Nurse Practitioner
Problem - There is a discrepancy in management of uncomplicated urinary tract infections(UTI). Practice differs regarding diagnostics,antibiotic, and follow-up. There is a documented rise in drug resistant pathogens especially regarding Escherichia coli and Trimethoprim-sulfamethoxazole which has led to the almost exclusive use of macrolides. Results -A chart audit and analysis of 204 clinic patients with documented UTI revealed that 94% were due to Escherica coli and 6% due to Citrobacter, Enterobacter, Klebsiella, and Proteus. Prescription practice differed although most providers did not document rationales for their selected antibiotic or presence/absence of culture. Most frequent prescriptions included Trimethoprim-sulfamethoxazole 160/180 mg BID for 3-7 days, Ciprofloxacin 100 mg BID for 3 days, and Nitrofurantoin 100 mg TID for 3-7 days. 52% received Trimethoprim-sulfamethoxazole which was sensitive to the microorganism, 33% were prescribed another drug when cultures documented sensitivity to Trimethoprim-sulfamethoxazole, and 15 % received Trimethoprim-sulfamethoxazole with culture identifying resistance to it. 85% of the patients could have effectively used Trimethoprim-sulfamethoxazole and with significant cost savings. Implications - A UTI protocol was developed which includes examination, culture, Trimethoprim-sulfamethoxazole 160/180 mg BID for 7 days, Pyridium 100 mg TID for 2 days, and evaluation of culture results and patient symptoms as follow-up. Alternative protocols are available for patients with allergy and demographics which correlate with antibiotic resistance. Patient outcomes, provider compliance, and cost effectiveness have generated positive results.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleAssessment of Prescription Practice and Microorganism Resistance to Antibiotics: Implications for Management of Uncomplicated Urinary Tract Infectionsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/148209-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Assessment of Prescription Practice and Microorganism Resistance to Antibiotics: Implications for Management of Uncomplicated Urinary Tract Infections</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Grossman, Sheila Carey, APRN, FNP, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Fairfield University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Professor &amp; Nurse Practitioner</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Sheilacg@aol.com</td></tr><tr><td colspan="2" class="item-abstract">Problem - There is a discrepancy in management of uncomplicated urinary tract infections(UTI). Practice differs regarding diagnostics,antibiotic, and follow-up. There is a documented rise in drug resistant pathogens especially regarding Escherichia coli and Trimethoprim-sulfamethoxazole which has led to the almost exclusive use of macrolides. Results -A chart audit and analysis of 204 clinic patients with documented UTI revealed that 94% were due to Escherica coli and 6% due to Citrobacter, Enterobacter, Klebsiella, and Proteus. Prescription practice differed although most providers did not document rationales for their selected antibiotic or presence/absence of culture. Most frequent prescriptions included Trimethoprim-sulfamethoxazole 160/180 mg BID for 3-7 days, Ciprofloxacin 100 mg BID for 3 days, and Nitrofurantoin 100 mg TID for 3-7 days. 52% received Trimethoprim-sulfamethoxazole which was sensitive to the microorganism, 33% were prescribed another drug when cultures documented sensitivity to Trimethoprim-sulfamethoxazole, and 15 % received Trimethoprim-sulfamethoxazole with culture identifying resistance to it. 85% of the patients could have effectively used Trimethoprim-sulfamethoxazole and with significant cost savings. Implications - A UTI protocol was developed which includes examination, culture, Trimethoprim-sulfamethoxazole 160/180 mg BID for 7 days, Pyridium 100 mg TID for 2 days, and evaluation of culture results and patient symptoms as follow-up. Alternative protocols are available for patients with allergy and demographics which correlate with antibiotic resistance. Patient outcomes, provider compliance, and cost effectiveness have generated positive results.</td></tr></table>en_GB
dc.date.available2011-10-26T09:41:51Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T09:41:51Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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