VA Antimicrobial Stewardship Helps with UTIs

BUFFALO, NY—Implementation of an antimicrobial stewardship program (ASP) appeared to significantly decrease duration of antibiotic therapy and length of hospitalization for complicated urinary tract infection at the Buffalo, NY, VAMC, without adversely affecting 30-day readmission rates.

The study, published in the American Journal of Infection Control, was undertaken to determine how effect such a program could be, according to study authors from the Buffalo VAMC.1

For the retrospective cohort study from Jan. 1, 2005, through Oct. 31, 2014, at the150-bed facility, researchers focused on male veterans admitted for treatment of complicated urinary tract infection, identified using ICD-9-CM codes. The study compared outcomes before and after implementation of a patient-centered ASP, including duration of antibiotic therapy, length of hospitalization, readmission within 30 days, and Clostridium difficile infection, while interventions resulting from the ASP were categorized.

Results indicated that, of the 1,268 patients screened, 241 met criteria for inclusion in the study. Duration of antibiotic therapy was significantly shorter in the ASP group—10.32 days vs. 11.96 days—as was length of hospitalization—5.76 days vs. 6.76 days. No difference was documented in 30-day readmission.

Overall, the ASP resulted in 170 interventions, an average of 1.39 per patient.

“ASPs may be useful to improve clinical outcomes in men with complicated urinary tract infection,” study authors concluded.

  1. Carbo JF, Ruh CA, Kurtzhalts KE, Ott MC, Sellick JA, Mergenhagen KA. Male veterans with complicated urinary tract infections: Influence of a patient-centered antimicrobial stewardship program. Am J Infect Control. 2016 Dec 1;44(12):1549-1553. doi: 10.1016/j.ajic.2016.04.239. Epub 2016 Jul 4. PubMed PMID: 27388268

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