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Related Concept Videos

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

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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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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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Quality documentation and reporting share essential characteristics that ensure they are practical and valuable resources for those who use them. These characteristics are:
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Related Experiment Video

Updated: Sep 10, 2025

Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
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Clinicians' Reasons for Non-Visit-Based, No-Infectious-Diagnosis-Documented Antibiotic Prescribing: A Sequential

Tiffany Brown1, Adriana Guzman2, Ji Young Lee1

  • 1Department of Medicine, Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.

Antibiotics (Basel, Switzerland)
|August 28, 2025
PubMed
Summary

Many ambulatory antibiotic prescriptions lack clear infection diagnoses. Most non-visit-based antibiotic orders are for patient symptoms, but some reasons, like prescribing for family, are concerning.

Keywords:
anti-bacterial agentsantimicrobial stewardshiphealth services researchinappropriate prescribingpractice patterns, physicians’quality of healthcare

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Area of Science:

  • Infectious Diseases
  • Health Services Research
  • Clinical Informatics

Background:

  • Approximately 20% of ambulatory antibiotic prescriptions are non-visit-based.
  • Around 30% of these prescriptions lack an infection-related diagnosis code.
  • Understanding prescribing rationale is crucial for antimicrobial stewardship.

Purpose of the Study:

  • To identify the prescribing rationale for ambulatory antibiotic prescriptions, particularly those lacking visit or infection-related diagnosis documentation.
  • To analyze the frequency and types of reasons behind non-visit-based antibiotic prescribing.

Main Methods:

  • Electronic health records (EHR) from a Midwest health system were queried for oral antibiotic prescriptions (November 2018 - February 2019).
  • Visit, procedure, lab, department, and diagnosis codes were examined.
  • For non-visit-based, no-infectious-diagnosis-documented prescriptions, EHRs were manually reviewed, and prescribers were surveyed if documentation was absent.

Main Results:

  • Of 47,619 total antibiotic prescriptions, 2608 (6%) were eligible for review.
  • A documented rationale existed for 92% of these prescriptions.
  • Common reasons included patient symptoms (71%), symptom persistence (18%), travel (17%), and lab/imaging results (11%).
  • Prescriber-stated reasons for undocumented prescriptions included patient travel (19%), prescribing for family (19%), and undocumented diagnoses (18%).

Conclusions:

  • Non-visit-based antibiotic prescriptions without documented infection diagnoses are frequently driven by patient-reported symptoms.
  • Other reasons, including upcoming travel and prescribing for family members, were also identified.
  • The study highlights the need for improved documentation and addresses potential issues in ambulatory antibiotic prescribing practices.