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Symptom Documentation Before Antibiotics for Recurrent Urinary Tract Infections
Alexandra Kuzma1, Elizabeth Critchlow2, Nathanael Koelper3
1From the Department of Obstetrics and Gynecology, Crozer Health, Upland, PA.
Urogynecology (Philadelphia, Pa.)
|December 23, 2024
Summary
Sparse documentation of urinary tract infection (UTI) symptoms in older women with recurrent UTIs may hinder antibiotic stewardship. Improved symptom recording is crucial for appropriate antibiotic prescribing.
Area of Science:
- Geriatric Medicine
- Infectious Diseases
- Pharmacology
Background:
- Antibiotic stewardship is crucial for managing urinary tract infections (UTIs).
- Inadequate symptom documentation before antibiotic prescription can lead to suboptimal antibiotic use.
- Recurrent UTIs in older women pose a significant health challenge.
Purpose of the Study:
- To quantify the number and types of urinary tract infection (UTI) symptoms documented in the medical records of older women with recurrent UTIs.
- To compare symptom documentation across different medical specialties during antibiotic prescribing encounters.
- To identify gaps in documentation that could impact antibiotic stewardship.
Main Methods:
- Retrospective cohort study analyzing 454 encounters from 175 women aged 65+ with recurrent UTIs.
- Data extraction included documented symptoms and urine culture results.
- Encounters were categorized by medical specialty (primary care, urology, OB/GYN, ED/urgent care).
Main Results:
- A median of 1 UTI-specific symptom was documented per encounter, declining over time.
- 25% of encounters had no UTI symptoms documented; 49% had 2 or more.
- Even with positive urine cultures (337 encounters), 19% lacked documented UTI symptoms and 9% lacked any symptom documentation.
Conclusions:
- Symptom documentation for antibiotic prescribing in older women with recurrent UTIs is notably sparse across all specialties.
- This care gap highlights a critical opportunity to enhance antibiotic stewardship through better clinical documentation practices.
- Standardizing and improving the recording of urinary symptoms is essential for appropriate UTI management.
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