A Response to "Top Ten Myths Regarding the Diagnosis and Treatment of Urinary Tract Infections".
نویسندگان
چکیده
BACKGROUND Urinary tract infections (UTI) are the most common type of infection in the United States. A Centers for Disease Control and Prevention report in March 2014 regarding antibiotic use in hospitals reported "UTI" treatment was avoidable at least 39% of the time. The accurate diagnosis and treatment of UTI plays an important role in cost-effective medical care and appropriate antimicrobial utilization. OBJECTIVE We summarize the most common misperceptions of UTI that result in extraneous testing and excessive antimicrobial treatment. We present 10 myths associated with the diagnosis and treatment of UTI and succinctly review the literature pertaining to each myth. We explore the myths associated with pyuria, asymptomatic bacteriuria, candiduria, and the elderly and catheterized patients. We attempt to give guidance for clinicians facing these clinical scenarios. DISCUSSION From our ambulatory, emergency department, and hospital experiences, patients often have urine cultures ordered without an appropriate indication, or receive unnecessary antibiotic therapy due to over-interpretation of the urinalysis. CONCLUSIONS Asymptomatic bacteriuria is common in all age groups and is frequently over-treated. A UTI diagnosis should be based on a combination of clinical symptoms with supportive laboratory information. This review will assist providers in navigating common pitfalls in the diagnosis of UTI.
منابع مشابه
Top Ten Myths regarding the Diagnosis and Treatment of Urinary Tract Infections
*Infectious Diseases and Critical Care Clinical Pharmacy, University of Wisconsin Hospital and Clinics, Madison, Wisconsin, †Hospital Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, ‡Department of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, and §Infectious Diseases, University of Wisconsin Scho...
متن کاملThe Prevalence of CTX-M Beta-Lactamase Gene in Urinary Tract Infections in patients referring to Bonab city Hospitals
Background: Urinary Tract Infection (UTI) is one of the most common bacterial infections, and several studies have reported the prevalence of UTI caused by ESBL-producing E.coli strains in different cities of Iran. The aim of this study was to evaluate antibiotic resistant UTI factors in outpatients and determine the prevalence of ctx-m gene in ESBL-producing E. coli strains of Bonab (East Azer...
متن کاملEvaluation of antibiotic resistance associated with ophthalmic oqxAB pumps in Klebsiella pneumoniae causing urinary tract infection
Background: The urinary tract infection is the secondary most common human infection. Colon bacteria, including Klebsiella pneumonia, are the main cause of urinary tract infections. The occurrence of the antibiotic resistance is a major problem in the treatment of infections. Beta- lactamases and efflux pumps constitute the major defense mechanisms of antibiotic resistance of Klebsiella pneumon...
متن کاملA comparative study of the prevalence of extended-spectrum β-lactamaseproducing Escherichia coli among urinary and fecal Escherichia coli isolates of women with urinary tract infection in Kerman city
Background & Aim: Important challenge for treatment of urinary tract infections is the spread of extended-spectrum beta-lactamases (ESBLs) producing Escherichia coli. Therefore, the frequencies of main beta-lactamase genes, resistance to beta-lactams and the ability of ESBLs production in urinary and fecal Escherichia coli of women with urinary tract infections were compared. Methods: In 60 Es...
متن کاملObstructive bacterial cystitis following cystotomy in a Persian cat
Feline lower urinary tract diseases are known to be life threatening conditions in cats, especially when they occur as obstructive diseases in males. Early diagnosis and treatment is necessary, otherwise it may lead to death. A 3-year-old male Persian cat was referred to the clinic with a history of anuria, lethargy, loss of appetite and exploratory cystotomy 6 months ago due to urethral obstru...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- The Journal of emergency medicine
دوره 52 5 شماره
صفحات -
تاریخ انتشار 2016