Implementation of Diagnostic Stewardship to Improve Urinary Tract Infection Antibiotic Use Across 3 Medical Centers
Conditional reflex urine culturing had a large decrease on UTI antibiotic DOTs and urine cultures performed. Health systems or medical centers starting urine culture diagnostic stewardship should implement conditional reflex urine culturing first. Article Summary: A multicenter pragmatic pre-/poststudy in Veterans Administration hospitals found that conditional reflex urine culturing significantly reduced urinary tract infection antibiotic use and urine cultures without increasing bacteremia, highlighting its potential as a high-value diagnostic stewardship intervention among older hospitalized adults.
Authors
- Tola Ewers (ORCID: https://orcid.org/0000-0002-3078-7428)
- Lisa Pineles (ORCID: https://orcid.org/0000-0002-2377-5971)
- Charlesnika Tyon Evans (ORCID: https://orcid.org/0000-0002-0696-8288)
- Christopher J. Crnich (ORCID: https://orcid.org/0000-0002-9320-9262)
- Daniel J. Morgan (ORCID: https://orcid.org/0000-0002-9467-4019)
- Barbara W. Trautner (ORCID: https://orcid.org/0000-0001-7986-9099)
- José Cadena (ORCID: https://orcid.org/0000-0002-6161-7480)
- Sarah L. Krein (ORCID: https://orcid.org/0000-0003-2111-8131)
- Judith Strymish (ORCID: https://orcid.org/0000-0002-3711-0639)
- Kimberly C. Claeys (ORCID: https://orcid.org/0000-0001-6895-604X)
- Lishan Cao
- Kalpana Gupta (ORCID: https://orcid.org/0000-0002-6766-3576)
- Kelly Coffey (ORCID: https://orcid.org/0000-0003-0502-2914)
- Clayton H. Brown (ORCID: https://orcid.org/0000-0002-0748-4509)
- Sean O’Neil
- Prakash Balasubramanian
Institutions
- University of Maryland, Baltimore (US)
- Michael E. DeBakey VA Medical Center (US)
- VA Boston Healthcare System (US)
- Edward Hines, Jr. VA Hospital (US)
- VA Ann Arbor Healthcare System (US)
- VA Center for Clinical Management Research (US)
- William S. Middleton Memorial Veterans Hospital (US)
- South Texas Veterans Health Care System (US)
- Texas Center for Infectious Disease (US)
- VA Maryland Health Care System (US)
Publication Details
- Journal
- Clinical Infectious Diseases
- Published
- 2025-07-24
- DOI
- https://doi.org/10.1093/cid/ciaf411
- Citations
- 2
- Primary Topic
- Urinary Tract Infections Management
- Type
- article
- Field-Weighted Citation Impact
- 2.71