Background: Indiscriminate orders for urinalysis and urine cultures (UC) drive inappropriate antibiotic treatment (Abx), especially in older adults with mental health disorders. Lack of data regarding the prevalence of and treatment for infections in acute geriatric psychiatric units (GPU) motivated us to initiate this project.
Aim: Our goal was to improve urine test utilization and reduce unnecessary Abx for asymptomatic bacteriuria (ASB) and contaminated UC. Methods: This retrospective review and prospective evaluation of bundled interventions was conducted in a 22- bed GPU in a community-based teaching hospital. Four hundred twenty-seven (427) patient records were reviewed for Abx and indication and 157 patients were assessed for the impact of bundled interventions.
Results: Near 27% received Abx, primarily for a misdiagnosed urinary tract infection. Only 20% met clinical criteria; 80% were unnecessarily treated for ASB or contaminated cultures. Over two-thirds of the Abx consisted of fluoroquinolones or trimethoprim-sulfamethoxazole, neither of which are recommended due to adverse events and/or resistance. The impact of bundled interventions was marginally effective.
Conclusion: Urinalysis and UC are indiscriminately ordered in older adults, resulting in inappropriate Abx with non-recommended agents. Urinalysis should not be a requirement for admission in asymptomatic patients given the high prevalence of ASB and pyuria in older adults. There is an opportunity for more collaboration within referring networks to standardize best practice.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8360214 | PMC |
| http://dx.doi.org/10.4103/ijabmr.IJABMR_599_20 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Association of Preoperative Cartilage T1ρ Values With Progression of Knee Osteoarthritis 10 Years After Anatomical Double-Bundle ACL Reconstruction: Follow-up of a Previous Prospective Study.
Orthop J Sports Med
January 2025
Center for Preventive Medical Sciences, Chiba University, Chiba, Japan.
Background: The factors contributing to osteoarthritis progression after anterior cruciate ligament (ACL) injury and reconstruction (ACLR) are not fully understood. Quantitative magnetic resonance imaging (MRI) offers a noninvasive way to evaluate cartilage biochemical composition using T1ρ mapping, thereby detecting early cartilage degeneration. The specific impact of preoperative quantitative MRI on long-term outcomes after ACLR remains underreported.
View Article and Find Full Text PDFubiquitin ligase regulates dichotomous spermatogenesis in .
Front Cell Dev Biol
January 2025
Hubei Key Laboratory of Insect Resources Utilization and Sustainable Pest Management, College of Plant Science and Technology, Huazhong Agricultural University, Wuhan, Hubei, China.
Spermatogenesis in Lepidoptera holds significant importance due to its unique process of dichotomous spermatogenesis, yielding eupyrene and apyrene spermatozoa through a complex molecular mechanism. While E3 ubiquitin ligases are known to play vital roles in spermatogenesis across various processes, their functions in dichotomous spermatogenesis remain less known. We utilized the RNAi, biochemical and microscopic procedures to unravel the function of in dichotomous spermatogenesis of adult .
View Article and Find Full Text PDFComputational Model of the Effective Thermal Conductivity of a Bundle of Round Steel Bars.
Materials (Basel)
January 2025
Institute of Electric Power Engineering, Czestochowa University of Technology, Armii Krajowej 17, 42-200 Czestochowa, Poland.
During the heat treatment of round steel bars, a heated charge in the form of a cylindrically formed bundle is placed in a furnace. This type of charge is a porous granular medium in which a complex heat flow occurs during heating. The following heat transfer mechanisms occur simultaneously in this medium: conduction in bars, conduction within the gas, thermal radiation between the surfaces of the bars, and contact conduction across the joints between the adjacent bars.
View Article and Find Full Text PDFInfluence of Electrostatic Interactions on the Self-Assembly of Charged Peptides.
Gels
January 2025
Faculty of Medicine, Dalian University of Technology, Dalian 116033, China.
Peptides can be designed to self-assemble into predefined supramolecular nanostructures, which are then employed as biomaterials in a range of applications, including tissue engineering, drug delivery, and vaccination. However, current self-assembling peptide (SAP) hydrogels exhibit inadequate self-healing capacities and necessitate the use of sophisticated printing apparatus, rendering them unsuitable for 3D printing under physiological conditions. Here, we report a precisely designed charged peptide, Z5, with the object of investigating the impact of electrostatic interactions on the self-assembly and the rheological properties of the resulting hydrogels.
View Article and Find Full Text PDFComparative analysis of biodiversity, physiology, and anatomical adaptations in riparian flora exposed to industrial pollution stress.
Sci Rep
January 2025
Department of Botany, Division of Science and Technology, University of Education, Lahore, Punjab, Pakistan.
Anthropogenic activities such as industrial pollution of water bodies possess threat to floras leading to extinction and endangerment. This study investigates the impact of industrial pollution on vegetation along River Chenab and its associated drains. Rivers and channels transporting industrial effluents have been determined to be significantly contaminated.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!