Impact of Education and Data Feedback on Antibiotic Prescribing for Urinary Tract Infections in the Emergency Department: An Interrupted Time Series Analysis

The ASET team led a study on antibiotic prescribing for UTIs in emergency departments published in the journal Clinical Infectious Diseases. 

Urinary tract infections (UTIs) are often misdiagnosed or treated with exceedingly broad-spectrum antibiotics, leading to negative downstream effects. We aimed to implement antimicrobial stewardship (AS) strategies targeting UTI prescribing in the emergency department (ED).

Overall, 8,742 distinct patients with 10,426 patient encounters were included. Ninety-two percent of all encounters (n=9,583) were diagnosed with cystitis and 8.1% with pyelonephritis (n=843). There was an initial 15% increase in guideline-concordant antibiotic prescribing in Phase 1 compared to the pre-intervention period (incidence rate ratio [IRR] 1.15; 95% confidence interval [CI] 1.03 to 1.29). A significant increase of guideline-concordant prescriptions was seen with every two-week interval during Phase 2 (IRR 1.03; 95% CI 1.01 to 1.04).

This multifaceted AS intervention involving a guideline, education, and provider-specific feedback increased guideline-concordant antibiotic choices for treat-and-release patients in the ED.

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