Issue link: https://beckershealthcare.uberflip.com/i/1191144
31 ANTIBIOTIC RESISTANCE & STEWARDSHIP Why clinicians should stop ordering so many urine tests By Mackenzie Bean M any physicians order urine tests out of habit, not necessity, which can contribute to antibiotic over- use, according to e New York Times. Urine cultures oen test positive for bacte- ria even though patients aren't experiencing symptoms of infection, which is referred to as asymptomatic bacteriuria. is trend is especially common in older patients. Many physicians automatically write patients an antibiotic prescription for a positive urine culture, even if it isn't always needed, according to NYT. "Once a clinician sees bacteria in the urine, the reflex is, you can't ignore it. You want to treat it," Christine Soong, MD, head of hospital medicine at Sinai Health System in Toronto, told the publication. Public health experts and researchers have tried to address this propensity for overtreat- ment with limited success. Now, they're taking a new approach: trying to prevent clinicians from ordering unnecessary urine tests. Health systems are getting on board with this effort by adding pop-up alerts when physicians attempt to order a urine culture in the EHR, among other initiatives. Dr. Soong said her hospital is withholding test results unless physicians request them from lab services. This strategy led to a 36 percent drop in antibiotic prescriptions written for asymptomatic bacteriuria, according to NYT. n Guidelines on community-acquired pneumonia updated By Anuja Vaidya C linical guidelines focused on the diagnosis and treat- ment of adults with pneumonia acquired outside the hospital setting have been updated. The American Thoracic Society and the Infectious Diseas- es Society of America jointly published the new guidelines in the October issue of American Journal of Respiratory and Critical Care Medicine. A 15-member panel produced the guidelines. The guidelines offer clinical recommendations on treat- ment decisions for patients with community-acquired pneumonia. The new guidelines differ from the previ- ous ones published in 2007 in several ways, including additional recommendations for disease management. These include recommending more microscopic studies of respiratory tract samples in some community-acquired patients. This aims to avoid unnecessary antibiotic pre- scriptions for drug-resistant bacteria. "Not only has there been new data in the past decade, but there is now a strong national and international focus on antibiotic stewardship," said Grant Waterer, MBBS, PhD, co-chair of the guideline committee and a professor of medicine at the University of Western Australia. "It was time to update the guideline so that clinicians could be certain they were still practicing evidence-based care." n PH: 1-800-842-7771 Email: biocontrols@rgf.com Web: www.rgf.com/rgf-biocontrols