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Antimicrobial Stewardship and Urinary Tract Infections
#MMPMID27025743
Abbo LM
; Hooton TM
Antibiotics (Basel)
2014[May]; 3
(2
): 174-92
PMID27025743
show ga
Urinary tract infections are the most common bacterial infections encountered in
ambulatory and long-term care settings in the United States. Urine samples are
the largest single category of specimens received by most microbiology
laboratories and many such cultures are collected from patients who have no or
questionable urinary symptoms. Unfortunately, antimicrobials are often prescribed
inappropriately in such patients. Antimicrobial use, whether appropriate or
inappropriate, is associated with the selection for antimicrobial-resistant
organisms colonizing or infecting the urinary tract. Infections caused by
antimicrobial-resistant organisms are associated with higher rates of treatment
failures, prolonged hospitalizations, increased costs and mortality.
Antimicrobial stewardship consists of avoidance of antimicrobials when
appropriate and, when antimicrobials are indicated, use of strategies to optimize
the selection, dosing, route of administration, duration and timing of
antimicrobial therapy to maximize clinical cure while limiting the unintended
consequences of antimicrobial use, including toxicity and selection of resistant
microorganisms. This article reviews successful antimicrobial stewardship
strategies in the diagnosis and treatment of urinary tract infections.
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