Reducing Antibiotic Consumption in Patients with Asymptomatic Bacteriuria: A Bi-directional Approach

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" Reducing Antibiotic Consumption in Patients with Asymptomatic Bacteriuria: A Bi-directional Approach "
Mozafarihashjin, Mohammad McGeer, Allison Joan

Document Type	:	Latin Dissertation
Language of Document	:	English
Record Number	:	1052655
Doc. No	:	TL51772
Main Entry	:	Mozafarihashjin, Mohammad
Title & Author	:	Reducing Antibiotic Consumption in Patients with Asymptomatic Bacteriuria: A Bi-directional Approach\ Mozafarihashjin, MohammadMcGeer, Allison Joan
College	:	University of Toronto (Canada)
Date	:	2019
Degree	:	M.Sc.
student score	:	2019
Note	:	146 p.
Abstract	:	Objectives: To assess safety and effectiveness of not processing midstream urine (MSU) in adults to reduce asymptomatic bacteriuria (ASB) treatment, and find a biomarker that differentiates symptomatic urinary tract infection (SUTI) from ASB in adults. Methods: From 11/2013-04/2019 MSU for surgical/medical in-patients were routinely not processed. Patients were followed up for 4 and 30 days. Primary outcome was safety; secondary outcomes were antibiotic use, lab workload, and rate/proportion of MSU submitted/processed. A systematic review was conducted to identify potential biomarkers. Results: In 912 patients, no serious adverse events (AE) and 6 (0.66%) non-serious AE occurred due to not processing MSU. Processed MSU proportion, submitted MSU rate, and lab workload decreased (P=0.002; P=0.02; 5 person-days/year). Ninety-eight patients avoided antibiotics. Urine IL-6 and IL-8 were the most promising biomarkers. Conclusion: Not processing MSU reduces ASB treatment safely and effectively. Urine IL-6 and IL-8 could possibly differentiate ASB from SUTI.
Descriptor	:	Epidemiology
	:	Health sciences
	:	Medicine
Added Entry	:	McGeer, Allison Joan
Added Entry	:	University of Toronto (Canada)