Antibiotic Stewardship in Lower Urinary Tract Infections Among the Elderly at a District General Hospital.
| Title: | Antibiotic Stewardship in Lower Urinary Tract Infections Among the Elderly at a District General Hospital. |
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| Authors: | Mithrakumar P; Internal Medicine, Northampton General Hospital, Northampton, GBR.; Barua M; Diabetes and Endocrinology, Walsall Manor Hospital, Walsall Healthcare NHS Trust, Birmingham, GBR. |
| Source: | Cureus [Cureus] 2025 Oct 20; Vol. 17 (10), pp. e95002. Date of Electronic Publication: 2025 Oct 20 (Print Publication: 2025). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Cureus, Inc Country of Publication: United States NLM ID: 101596737 Publication Model: eCollection Cited Medium: Print ISSN: 2168-8184 (Print) Linking ISSN: 21688184 NLM ISO Abbreviation: Cureus Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: Palo Alto, CA : Cureus, Inc. |
| Abstract: | Objectives: We aimed to evaluate the management of lower urinary tract infections (LUTIs) in elderly inpatients, to determine the prevalence of inappropriate treatment of asymptomatic bacteriuria (ASB), and to assess the impact of targeted educational interventions on antibiotic prescribing accuracy.; Settings: An acute general hospital in the East Midlands of the United Kingdom.; Participants: A total of 77 patients aged 65 years and older who underwent urine culture for suspected lower urinary tract infection were included in the study.; Design: This was a prospective case series of emergency hospital admissions collected over eight months in acute elderly medicine wards, with two educational interventions implemented during the second and third months of the study period.; Methods: Data relating to demographics, catheterization status, presenting symptoms, urine dipstick usage, culture collection methods, and antibiotic prescription patterns were obtained from electronic and paper records as part of audit number 1688 registered at the hospital trust. Interventions included the display of an informational poster based on NICE guidelines and a dedicated educational teaching session for clinicians. In total, 19 patients were involved pre-intervention. A total of 58 patients were involved post-intervention. Among the post-intervention cohort, 32 patients were involved after the poster intervention, and 17 patients were involved following the teaching intervention. Several months following the intervention, nine patients were involved in the study.; Results: Initial findings revealed suboptimal adherence to national guidelines, with 50% (n=5) of asymptomatic patients with negative cultures inappropriately prescribed antibiotics. Following the poster intervention, prescribing was found to be three-and-a-half times more appropriate for LUTIs than the pre-intervention period (OR=3.61, 95% CI: 1.08-12.03, Ꭓ2=4.56, p=0.033). Compared to the pre-intervention period, antibiotic prescribing was found to be five times more appropriate (OR=5.05, 95% CI: 0.96-26.66, Ꭓ2=3.91, p=0.048) after all educational interventions were implemented. Catheter-associated infections also showed a significant reduction, albeit with poor statistical correlation. Conclusion: Targeted educational interventions, including informational posters and teaching sessions, improved appropriate diagnosis and antibiotic prescribing for LUTIs and ASB in elderly hospitalized patients within the scope of this study.; (Copyright © 2025, Mithrakumar et al.) |
| Competing Interests: | Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Northampton General Hospital issued approval 1688. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. |
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| Contributed Indexing: | Keywords: antibiotic stewardship (ams); asymptomatic bacteriuria (asbu); catheter-associated urinary tract infection; clostridioides difficile infection; infection prevention and control; lower urinary tract infection; methicillin resistant staphylococcus aureus (mrsa); s: nosocomial infections; urine culture; urine dipstick test |
| Entry Date(s): | Date Created: 20251121 Date Completed: 20251121 Latest Revision: 20251123 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC12629353 |
| DOI: | 10.7759/cureus.95002 |
| PMID: | 41267720 |
| Database: | MEDLINE |
Journal Article