Most women receive inappropriate treatment for urinary tract infections
Rural-Urban divide found in outpatient antibiotic prescribing for common condition
2021-02-24
(Press-News.org) NEW YORK (February 24, 2021) -- Nearly half of women with uncomplicated urinary tract infections received the wrong antibiotics and almost three-quarters received prescriptions for longer than necessary, with inappropriately long treatment durations more common in rural areas, according to a study of private insurance claims data published today in Infection Control & Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.
"Inappropriate antibiotic prescriptions for uncomplicated urinary tract infections are prevalent and come with serious patient- and society-level consequences," said Anne Mobley Butler, PhD, lead author of the study and assistant professor of medicine and surgery at Washington University School of Medicine, St. Louis. "Our study findings underscore the need for antimicrobial stewardship interventions to improve outpatient antibiotic prescribing, particularly in rural settings."
Researchers studied insurance claims data for 670,400 women ages 18 to 44 who received an outpatient diagnosis of uncomplicated urinary tract infection between April 2011 and June 2015. They identified filled antibiotic prescriptions, assessed adherence to clinical guidelines, and compared rural and urban antibiotic usage patterns.
Rural patients were more likely to receive a prescription for an inappropriately long duration of therapy than urban patients, according to an analysis of geographic data from the claims database. While use of both inappropriate antibiotic choice and inappropriate duration of prescriptions declined slightly over the study period, inappropriate prescriptions continued to be common with 47% of prescriptions written for antibiotics outside guideline recommendations and 76% for an inappropriate duration, nearly all of which were longer than recommended.
"Accumulating evidence suggests that patients have better outcomes when we change prescribing from broad-acting to narrow-spectrum antibiotics and from longer to shorter durations," Butler said. "Promoting optimal antimicrobial use benefits the patient and society by preventing avoidable adverse events, microbiome disruption, and antibiotic-resistant infections."
Clinicians should periodically review clinical practice guidelines, even for common conditions, to determine the ideal antibiotic and treatment duration, Butler said. Auditing outpatient antibiotic prescribing patterns and periodic feedback to healthcare provider helps remind clinicians of the best practices and improves antibiotic prescribing. However, additional research should be performed to understand and ultimately improve rural outpatient antibiotic prescribing practices for urinary tract infections and other common conditions.
Possible explanations for study findings, which are consistent with other research reflecting rural disparities, may be that rural providers may not be as aware of current antibiotic treatment guidelines. In addition, urban providers who treat rural patients may prescribe longer antibiotic durations because of distance-to-care barriers in case symptoms persist. Further research is needed to identify reasons for higher inappropriate prescribing in rural settings.
INFORMATION:
Abbye Clark, Michael Durkin, Margaret Olsen, Matthew Keller, Yinjiao Ma, Caroline O'Neil, Anne Butler. "Rural-urban differences in antibiotic prescribing for uncomplicated urinary tract
infection." Infection Control & Hospital Epidemiology. Web (February 24, 2021).
About ICHE
Published through a partnership between the Society for Healthcare Epidemiology of America and Cambridge University Press, Infection Control & Hospital Epidemiology provides original, peer reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. ICHE is ranked 41st out of 89 Infectious Disease Journals in the latest Web of Knowledge Journal Citation Reports from Thomson Reuters.
The Society for Healthcare Epidemiology of America (SHEA) is a professional society representing more than 2,000 physicians and other healthcare professionals around the world who possess expertise and passion for healthcare epidemiology, infection prevention, and antimicrobial stewardship. The society's work improves public health by establishing infection-prevention measures and supporting antibiotic stewardship among healthcare providers, hospitals, and health systems. This is accomplished by leading research studies, translating research into clinical practice, developing evidence-based policies, optimizing antibiotic stewardship, and advancing the field of healthcare epidemiology. SHEA and its members strive to improve patient outcomes and create a safer, healthier future for all. Visit SHEA online at http://www.shea-online.org, http://www.facebook.com/SHEApreventingHAIs and @SHEA_Epi.
About Cambridge University Press
Cambridge University Press is part of the University of Cambridge. It furthers the University's mission by disseminating knowledge in the pursuit of education, learning and research at the highest international levels of excellence. Its extensive peer-reviewed publishing lists comprise 45,000 titles covering academic research, professional development, over 400 research journals, school-level education, English language teaching and bible publishing. Playing a leading role in today's international market place, Cambridge University Press has over 50 offices around the globe, and it distributes its products to nearly every country in the world.
For further information about Cambridge University Press, visit Cambridge.org.
ELSE PRESS RELEASES FROM THIS DATE:
2021-02-24
In the first few months of their lives, babies cry, babble, gurgle and make a variety of other peculiar sounds. It can be difficult to imagine that they are actually laying the foundations for later speech with these utterances. However, there is a determining element that proves that even their cries can be assigned to a particular language: the speech melody - or, more accurately: prosody.
"Every language is characterised by specific musical elements, which we call prosody," says Kathleen Wermke. Prosody, in simple terms, is the combination of intonation (melody) and rhythm. Earlier studies have shown that even newborns are able to distinguish different languages, like German ...
2021-02-24
Everyone knows 2 + 2 = 4, but what about mosquitoes plus malaria? Lauren Childs, an assistant professor in the Department of Mathematics at Virginia Tech, says there's an equation for that too.
Childs recently co-authored a report with a team from Harvard University on the role of natural mosquito behavior on transmission of a disease that threatens half the world's population.
The study, "Multiple blood feeding in mosquitoes shortens the Plasmodium falciparum incubation period and increases malaria transmission potential," was published in the December 2020 issue of PLOS Pathogens.
"Worldwide there are about 400,000 deaths and 200 million cases each year from malaria," said Childs, a faculty member with the Virginia Tech College ...
2021-02-24
Prisons with more green space have lower levels of violence and self-harm, according to new research at the University of Birmingham and Utrecht University.
The study is the first to attempt large-scale mapping of green space within prison environments and link it to well-being in a robust, statistically significant way. The results are published in Annals of the American Association of Geographers.
The researchers used GIS mapping to identify the percentages of green space (such as trees, lawns and shrubbery) within prisons in England and Wales. They ...
2021-02-24
A new report shows that British citizens who are missing abroad were more than twice as likely to be found by UK police as police in the country of disappearance.
Research by the Centre for the Study of Missing Persons (CSMP) at the University of Portsmouth also shows they were likely to be missing for much longer than if they'd disappeared in the UK.
The study found that British people who vanish abroad tend to be missing for extended periods, on average 134 days. This compares with 88 percent of people who go missing in the UK being found within the first 48 hours.
Dr Karen Shalev-Greene, Director of the ...
2021-02-24
Extreme weather driven by climate change is making power outages more commonplace even as the need for electricity-dependent home health equipment grows. In this context, battery storage can help protect medically vulnerable households, according to researchers at Columbia University Mailman School of Public Health. The article is published in the journal Futures.
For the millions reliant on electricity for home medical equipment, even short-term power outages can lead to a potentially life-threatening situation. Society's most vulnerable populations--elders, ...
2021-02-24
Heads or tails? If we toss two coins into the air, the result of one coin toss has nothing to do with the result of the other. Coins are independent objects. In the world of quantum physics, things are different: quantum particles can be entangled, in which case they can no longer be regarded as independent individual objects, they can only be described as one joint system.
For years, it has been possible to produce entangled photons - pairs of light particles that move in completely different directions but still belong together. Spectacular results have been achieved, for example in the field of quantum teleportation or quantum cryptography. Now, a new method has been ...
2021-02-24
Knowing the environmental and human-related variables that characterize the favorable areas for the incidence of the West Nile virus, a flavivirus that is transmitted from birds to humans by mosquitoes, is essential to identify those places in Europe at high risk of experiencing outbreaks, even before these are registered, thus enabling preventive measures to be taken.
Researchers of the Biogeography, Diversity and Conservation Group of the University of Malaga have developed risk models for West Nile Fever, the disease caused in humans by this virus, which, based on historical incidence data, may predict areas of future outbreaks a year in advance, as well as detect their intensity.
Artificial intelligence to develop risk ...
2021-02-24
Leesburg, VA, February 24, 2021--An open-access article in ARRS' American Journal of Roentgenology (AJR) describes the clinical and imaging features of axillary adenopathy detected during screening or diagnostic breast imaging after recent coronavirus disease (COVID-19) vaccination to inform the development of follow-up recommendations.
Shabnam Mortazavi of the University of California at Los Angeles reviewed electronic medical records to identify women with post-COVID-19 vaccination adenopathy found from December 2020 to February 2021. For mammography, Mortazavi considered a node abnormal when its size, shape, or density was deemed disproportionate to other axillary nodes (ipsilateral or contralateral). On ultrasound, she deemed ...
2021-02-24
With the voice commands "Alexa Skills," users can load numerous extra functions onto their Amazon voice assistant. However, these Skills can often have security gaps and data protection problems, as a team of researchers from the Horst Görtz Institute for IT Security at Ruhr-Universität Bochum (RUB) and North Carolina State University discovered, together with a former PhD student who started to work for Google during the project. They will present their work at the "Network and Distributed System Security Symposium (NDSS)" conference on 24 February 2021.
More than 90,000 Skills analyzed
In their study, the researchers ...
2021-02-24
Torino, February 24, 2021 - The eukaryotic cell is the basic unit of animals and plants. At the microscope, it looks highly structured and subdivided in many membrane-bound compartments. Each compartment has a specific function, and its membrane is populated by specific molecules. How does the cell preserve this amazing internal order, and (in the absence of pathologies) does not degrade into a shapeless bunch of molecules? Such degradation is countered by a continuous process of molecule sorting by which similar molecules are collected and dispatched to the "right" destinations, similarly to what happens when a house is kept clean and ...
LAST 30 PRESS RELEASES:
[Press-News.org] Most women receive inappropriate treatment for urinary tract infections
Rural-Urban divide found in outpatient antibiotic prescribing for common condition
