Diagnosis, Treatment, and Prevention of Urinary Tract Infections in Post-Acute and Long-Term Care Settings: A Consensus Statement From AMDA's Infection Advisory Subcommittee

Ashraf, Muhammad Salman; Gaur, Swati; Bushen, Oluma Y.; Chopra, Teena; Chung, Philip; Clifford, Kalin M.; Hames, Elizabeth Muller; Hertogh, Cees M.P.M.; Krishna, Amar; Mahajan, Dheeraj; Mehr, David R.; Nalls, Vycki; Rowe, Theresa; Schweon, Steven J.; Sloane, Philip D.; Trivedi, Kavita K.; Buul, Laura W van; Jump, Robin L.P.

doi:10.1016/j.jamda.2019.11.004

Cited by 38 publications

(26 citation statements)

References 91 publications

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“…15,[25][26][27][28][29] Monitoring and optimizing diagnostic and testing practices, in addition to antimicrobial use for these 3 indications, and specifically including urinary tract prophylaxis, which is mostly inappropriate, 15,21,25,30 should be a major focus of antimicrobial stewardship activities in nursing homes. Implementation of treatment guidelines for urinary tract infections that inform and standardize treatment decisions, like those from the Society of Post-Acute and Long-Term Care Medicine, 31 can help optimize antimicrobial use.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Use in a Cohort of US Nursing Homes, 2017

Thompson

Stone

Brown

et al. 2021

JAMA

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IMPORTANCE Controlling antimicrobial resistance in health care is a public health priority, although data describing antimicrobial use in US nursing homes are limited.OBJECTIVE To measure the prevalence of antimicrobial use and describe antimicrobial classes and common indications among nursing home residents. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional, 1-day point-prevalence surveys of antimicrobial use performed between April 2017 and October 2017, last survey date October 31, 2017, and including 15 276 residents present on the survey date in 161 randomly selected nursing homes from selected counties of 10 Emerging Infections Program (EIP) states. EIP staff reviewed nursing home records to collect data on characteristics of residents and antimicrobials administered at the time of the survey. Nursing home characteristics were obtained from nursing home staff and the Nursing Home Compare website.EXPOSURES Residence in one of the participating nursing homes at the time of the survey. MAIN OUTCOMES AND MEASURESPrevalence of antimicrobial use per 100 residents, defined as the number of residents receiving antimicrobial drugs at the time of the survey divided by the total number of surveyed residents. Multivariable logistic regression modeling of antimicrobial use and percentages of drugs within various classifications. RESULTS Among 15 276 nursing home residents included in the study (mean [SD] age, 77.6 [13.7] years; 9475 [62%] women), complete prevalence data were available for 96.8%. The overall antimicrobial use prevalence was 8.2 per 100 residents (95% CI, 7.8-8.8). Antimicrobial use was more prevalent in residents admitted to the nursing home within 30 days before the survey date (18.8 per 100 residents; 95% CI,3), with central venous catheters (62.8 per 100 residents; 95% CI, 56.9-68.3) or with indwelling urinary catheters (19.1 per 100 residents; 95% CI, 16.4-22.0). Antimicrobials were most often used to treat active infections (77% [95% CI, 74.8%-79.2%]) and primarily for urinary tract infections (28.1% [95% CI, 15.5%-30.7%]). While 18.2% (95% CI, 16.1%-20.1%) were for medical prophylaxis, most often use was for the urinary tract (40.8% [95% CI, 34.8%-47.1%]). Fluoroquinolones were the most common antimicrobial class (12.9% [95% CI, 11.3%-14.8%]), and 33.1% (95% CI, 30.7%-35.6%) of antimicrobials used were broad-spectrum antibiotics. CONCLUSIONS AND RELEVANCEIn this cross-sectional survey of a cohort of US nursing homes in 2017, prevalence of antimicrobial use was 8.2 per 100 residents. This study provides information on the patterns of antimicrobial use among these nursing home residents.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial Use in a Cohort of US Nursing Homes, 2017

Thompson

Stone

Brown

et al. 2021

JAMA

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“…Su consumo tiene gran acogida en la población, aunque no ha demostrado ser superior que la profilaxis antibiótica y por eso tiene un grado de recomendación débil. 7,67 Hay otras alternativas como la D-manosa que es un azúcar involucrado en la glicosilación de proteínas en el cuerpo humano. 68 Algunas teorías mencionan que su papel en la prevención de las IVU se basa en la alteración de la adherencia bacteriana a las células uroepiteliales.…”

Section: Prevención Y Profilaxis Antibióticaunclassified

Infección de vías urinarias no complicada en mujeres

Becerra

Parra

Trujillo

et al. 2021

Revista Urología Colombiana / Colombian Urology Journal

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ResumenLa infección de vías urinarias (IVU) es una patología común, que afecta a gran parte de la población y que generalmente se resuelve con manejo antibiótico. Se compone de una amplia variedad de entidades clínicas que pueden variar desde una cistitis no complicada hasta un shock séptico de origen urinario. Los patógenos etiológicos de la IVU no complicada están ampliamente establecidos y se han mantenido de forma consistente a lo largo del tiempo, siendo la Escherichia coli el microorganismo más predominante. En la actualidad, la resistencia bacteriana a los antibióticos es de gran preocupación y por esa razón, se busca optimizar la terapia antimicrobiana con el fin de disminuir la estancia hospitalaria, la severidad clínica de la infección y los costos a los sistemas de salud. La presente revisión, tiene como objetivo servir como guía para la correcta definición, clasificación, diagnóstico, tratamiento y prevención de la IVU no complicada.

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“…The first, a consensus document on diagnosis, treatment, and prevention of urinary tract infections written by the Infection Advisory Subcommittee of AMDAeThe Society for Post-Acute and Long-Term Care Medicine provides a well-researched, authoritative statement of recommendations for practice and the rationale for those recommendations. 2 The second article, reviewing data on 15,276 residents from 161 US nursing homes, reveals that a quarter of prescriptions for urinary tract disease are "prophylactic"da practice that is being viewed with increasing circumspection in the long-term care setting. 3 Alternatives to antibiotics for prevention of recurrent urinary infections do exist, and the research on these options is reviewed in a third article in this issue.…”

Section: Common Infections In the Nursing Homementioning

confidence: 99%