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Establishment and Characterization of UTI and CAUTI in a Mouse Model
Published on: June 23, 2015
Overtreatment of enterococcal bacteriuria
Eugene Lin1, Yogesh Bhusal, Deborah Horwitz
1Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
Archives of Internal Medicine
|January 11, 2012
Summary
Healthcare providers frequently overtreat asymptomatic enterococcal bacteriuria (ABU) with antibiotics, especially when pyuria is present. Optimizing antibiotic use is crucial given the low risk of complications from ABU.
Area of Science:
- Infectious Diseases
- Clinical Microbiology
- Pharmacology
Background:
- Enterococcal bacteriuria is common, but its clinical significance and appropriate management remain debated.
- Current treatment strategies may not align with established guidelines, leading to potential overuse of antibiotics.
Purpose of the Study:
- To evaluate the clinical outcomes associated with enterococcal bacteriuria.
- To assess adherence to Infectious Diseases Society of America (IDSA) guidelines for managing enterococcal bacteriuria.
Main Methods:
- Retrospective review of 339 patient records with enterococcal bacteriuria from two academic hospitals.
- Classification of cases into urinary tract infection (UTI) or asymptomatic bacteriuria (ABU) based on IDSA guidelines.
- Analysis of antibiotic appropriateness and subsequent Enterococcus infections.
Main Results:
- Over half of the cases (54.0%) were classified as asymptomatic bacteriuria (ABU).
- Antibiotics were inappropriately prescribed in 32.8% of ABU cases, with pyuria being a significant factor (OR, 3.27).
- Subsequent Enterococcus infections occurred in only 2.1% of all cases, with 1.1% in ABU.
Conclusions:
- Enterococcal asymptomatic bacteriuria is frequently overtreated, particularly in patients with pyuria.
- The low incidence of infectious complications suggests a need to refine antibiotic prescribing practices for enterococcal bacteriuria.
- Optimizing antibiotic use can reduce unnecessary treatment and potential adverse effects.
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