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Related Concept Videos

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

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A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
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Urinary Tract Infection IV: Nursing Management01:17

Urinary Tract Infection IV: Nursing Management

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In managing urinary tract infections (UTIs) in nursing, a comprehensive assessment is essential. Begin by gathering subjective data, such as the patient’s complaints of dysuria (painful urination), urinary frequency, urgency, suprapubic pain, and any lower abdominal discomfort. This information can be complemented by questions regarding previous UTIs, sexual activity, and personal hygiene practices, which can provide insight into risk factors. Objective assessment should focus on signs...
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Urine Studies II: Urine Culture and Sensitivity Test01:26

Urine Studies II: Urine Culture and Sensitivity Test

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A urine culture and sensitivity test is a diagnostic procedure used to identify urinary tract bacterial infections and determine the most effective antibiotics for treatment. This test is generally preferred when a patient shows manifestations of a urinary tract infection, such as frequent or painful urination, cloudy or foul-smelling urine, or lower abdominal pain.Purpose of the TestThe primary goals of a urine culture and sensitivity test are to:Determine the specific bacteria causing the...
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Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Urologic Endoscopic Procedure: Cystoscopic Examination01:28

Urologic Endoscopic Procedure: Cystoscopic Examination

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Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
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Urinary Tract Infection II: Pathophysiology01:25

Urinary Tract Infection II: Pathophysiology

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The pathophysiology of urinary tract infections (UTIs) encompasses several progressive stages, beginning with bacterial colonization and culminating in potential systemic complications if untreated. UTIs are primarily initiated by bacteria, such as Escherichia coli, which often originate from the gastrointestinal tract and migrate to the urinary system through the periurethral area. This migration can occur via several routes, including improper hygiene practices, sexual activity, or...
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Updated: Dec 31, 2025

Establishment and Characterization of UTI and CAUTI in a Mouse Model
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Practitioner Education and Feedback to Decrease Ciprofloxacin Prescriptions in Patients with Acute Uncomplicated

Richard F Guo1, Dinh L Nguyen2, Steven Park3

  • 1Department of Hospital Medicine, Kaiser Permanente Northwest, Portland, OR.

The Permanente Journal
|January 7, 2020
PubMed
Summary
This summary is machine-generated.

A study found that educating primary care practitioners and providing audit feedback significantly reduced ciprofloxacin prescriptions for acute uncomplicated cystitis (AUC). This intervention helps align prescribing practices with current guidelines, addressing antimicrobial resistance concerns.

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Area of Science:

  • Infectious Diseases
  • Antimicrobial Stewardship
  • Primary Care Medicine

Background:

  • Current guidelines recommend nonfluoroquinolone antibiotics for acute uncomplicated cystitis (AUC) due to resistance and side effect concerns.
  • Ciprofloxacin use for AUC deviates from recommended first-line treatments.

Purpose of the Study:

  • To evaluate if a multifaceted intervention, including education and feedback, could decrease ciprofloxacin prescribing by primary care practitioners for AUC.
  • To assess the impact of an educational intervention on antibiotic prescribing habits for uncomplicated urinary tract infections.

Main Methods:

  • A study involving primary care practitioners across three medical offices, with intervention and control groups.
  • The intervention included educational lectures, guideline summaries, prescription audits, and feedback on inappropriate antibiotic choices.
  • Prescription data for AUC encounters were collected during baseline, intervention, and postintervention phases.

Main Results:

  • Ciprofloxacin prescriptions decreased significantly in the intervention group (from 29.7% at baseline to 10.8% post-intervention).
  • The control group showed no significant change in ciprofloxacin prescribing rates.
  • Adjusted odds ratios for ciprofloxacin prescription were substantially lower in the intervention group post-intervention (0.29) and during the intervention period (0.80) compared to baseline.

Conclusions:

  • Multifaceted interventions combining education and audit-feedback are effective in reducing ciprofloxacin prescriptions for AUC.
  • This approach supports adherence to antimicrobial stewardship guidelines and may mitigate antimicrobial resistance.
  • Targeted educational and feedback strategies can modify practitioner prescribing behavior in primary care settings.