Appropriateness of antibiotic use for patients with asymptomatic bacteriuria or urinary tract infection with positive urine culture: a retrospective observational multi-centre study in Korea

被引：1

作者：

Jung, J. ^{[1
]}

Moon, S. M. ^{[2
]}

Kim, D. Y. ^{[3
]}

Kim, S-h. ^{[4
]}

Lee, W. J. ^{[5
]}

Heo, S. T. ^{[6
]}

Park, J. Y. ^{[7
]}

Bae, S. ^{[8
]}

Lee, M. J. ^{[9
]}

Kim, B.

Park, S. Y. ^{[10
,11
,12
,13
]}

Jeong, H. W. ^{[14
,15
]}

Kim, Y. ^{[16
]}

Kwak, Y. G. ^{[17
]}

Song, K-h. ^{[2
]}

Park, K-h. ^{[18
]}

Park, S. H. ^{[19
]}

Kim, Y. K.

Kim, E. S. ^{[20
]}

Kim, H. B. ^{[2
,21
]}

机构：

[1] Soonchunhyang Univ, Seoul Hosp, Dept Internal Med, Div Infect Dis, Seoul, South Korea

[2] Seoul Natl Univ, Coll Med, Dept Internal Med, Bundang Hosp, Seoul, South Korea

[3] Kyung Hee Univ, Sch Med, Dept Internal Med, Div Infect Dis,Kyung Hee Univ Hosp, Seoul, South Korea

[4] Sungkyunkwan Univ, Samsung Changwon Hosp, Div Infect Dis, Chang Won, South Korea

[5] Hallym Hosp, Dept Internal Med, Incheon, South Korea

[6] Jeju Natl Univ, Dept Internal Med, Div Infect Dis, Coll Med, Jeju, South Korea

[7] Chung Ang Univ Hosp, Dept Paediat, Seoul, South Korea

[8] Kyungpook Natl Univ, Sch Med, Dept Internal Med, Div Infect Dis, Daegu, South Korea

[9] Inje Univ, Sanggye Paik Hosp, Dept Internal Med, Seoul, South Korea

[10] Hanyang Univ, Coll Med, Dept Internal Med, Seoul, South Korea

[11] Yonsei Univ, Dept Hosp Med, Yongin Severance Hosp, Coll Med, Yongin, South Korea

[12] Yonsei Univ, Coll Med, Dept Biomed Syst Informat, Seoul, South Korea

[13] Yonsei Univ Hlth Syst, Yongin Severance Hosp, Ctr Digital Hlth, Yongin, South Korea

[14] Chungbuk Natl Univ, Coll Med, Dept Internal Med, Chungbuk, South Korea

[15] Chungbuk Natl Univ Hosp, Dept Internal Med, Cheongju, South Korea

[16] Wonkwang Univ, Coll Med, Dept Internal Med, Iksan, South Korea

[17] Inje Univ, Ilsan Paik Hosp, Dept Internal Med, Goyang, South Korea

[18] Chonnam Natl Univ, Med Sch, Dept Infect Dis, Gwangju, South Korea

[19] Catholic Univ Korea, Coll Med, Dept Internal Med, Seoul, South Korea

[20] Yonsei Univ, Wonju Coll Med, Dept Internal Med, Wonju, South Korea

[21] Seoul Natl Univ, Bundang Hosp, 82 Gumi Ro 173 Beon gil, Seongnam 13620, Gyeonggi Do, South Korea

来源：

JOURNAL OF HOSPITAL INFECTION | 2023年 / 140卷

关键词：

Antibiotic resistance; Quality assessment of antibiotic use; Asymptomatic bacteriuria; Urinary tract infection; DISEASES SOCIETY; DIAGNOSIS; UPDATE;

D O I：

10.1016/j.jhin.2023.07.022

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background: Antibiotic resistance threatens public health worldwide, and inappropriate use of antibiotics is one of the main causes. Aim: To evaluate qualitative use of antibiotics in asymptomatic bacteriuria (ABU) and urinary tract infection (UTI). Methods: Cases of positive urine culture (>= 10(5) colony-forning units/mL) performed in inpatient, outpatient and emergency departments in April 2021 were screened in 26 hospitals in the Republic of Korea. The cases were classified as ABU, lower UTI and upper UTI. The appropriateness of antibiotic use was evaluated retrospectively by infectious disease specialists using quality indicators based on clinical guidelines for ABU and UTI. Results: This study included a total of 2697 patients with ABU or UTI. The appropriateness of antibiotic use was assessed in 1157 patients with ABU, and in 677 and 863 patients with lower and upper UTI, respectively. Among the 1157 patients with ABU, 251 (22%) were prescribed antibiotics without appropriate indications. In 66 patients with ABU in which antibiotics were prescribed with appropriate indications, the duration was adequate in only 23 (34.8%) patients. The appropriateness of empirical and definite antibiotics was noted in 527 (77.8%) and 353 (68.0%) patients with lower UTI, and 745 (86.3%) and 583 (78.2%) patients with upper UTI, respectively. The duration of antibiotics was adequate in 321 (61.8%) patients with lower UTI and 576 (78.7%) patients with upper UTI. Conclusions: This nationwide qualitative assessment of antibiotic use in ABU and UTI revealed that antibiotics were often prescribed inappropriately, and the duration of antibiotics was unnecessarily prolonged. (c) 2023 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

引用

页码：79 / 86

页数：8

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