TY - JOUR
T1 - Resident‐Related Factors Influencing Antibiotic Treatment Decisions for Urinary Tract Infections in Dutch Nursing Homes
AU - Kolodziej, Lisa Marie
AU - Kuil, Sacha Daniëlle
AU - de Jong, Menno Douwe
AU - Schneeberger, Caroline
N1 - Funding Information: The PROGRESS study was funded by The Netherlands Organization for Health Research and Development (ZonMW) grant no 541001003. ZonMW, Laan van Nieuw Oost Indië 334, 2593 CE Den Haag, The Netherlands. Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022/2/1
Y1 - 2022/2/1
N2 - The aim of this cohort study was to identify resident‐related factors that influence antibiotic treatment decisions for urinary tract infections (UTIs) in nursing home residents and to provide an overview of the appropriateness of antibiotic treatment decisions according to the updated Dutch guideline for UTIs in frail older adults. The PROGRESS study dataset, consisting of 298 suspected UTI episodes in Dutch nursing home residents, was used. The presence of dysuria was associated with the highest frequency of antibiotic prescription (87.8%). Positive leukocyte esterase dipstick results showed the greatest increase in the risk of antibiotic prescription (RR 2.1, 95% CI 1.44 to 3.06). Treatment decisions were considered adequate in 64.1% of the suspected UTI episodes. Overtreat-ment occurred more often than undertreatment. Of the inadequate treatment decisions, 29.3% was due to treatment of UTI episodes in which solely non‐specific symptoms were present. A high pro-portion of nitrofurantoin prescriptions were incorrect in UTIs with signs of tissue invasion (54.8%), indwelling catheter‐associated UTIs (37.5%), and UTIs in men (29.2%). Although this is considered inadequate, non‐specific symptoms were associated with antibiotic prescription for suspected UTIs in Dutch nursing home residents and nitrofurantoin was inadequately prescribed in particular groups, such as men.
AB - The aim of this cohort study was to identify resident‐related factors that influence antibiotic treatment decisions for urinary tract infections (UTIs) in nursing home residents and to provide an overview of the appropriateness of antibiotic treatment decisions according to the updated Dutch guideline for UTIs in frail older adults. The PROGRESS study dataset, consisting of 298 suspected UTI episodes in Dutch nursing home residents, was used. The presence of dysuria was associated with the highest frequency of antibiotic prescription (87.8%). Positive leukocyte esterase dipstick results showed the greatest increase in the risk of antibiotic prescription (RR 2.1, 95% CI 1.44 to 3.06). Treatment decisions were considered adequate in 64.1% of the suspected UTI episodes. Overtreat-ment occurred more often than undertreatment. Of the inadequate treatment decisions, 29.3% was due to treatment of UTI episodes in which solely non‐specific symptoms were present. A high pro-portion of nitrofurantoin prescriptions were incorrect in UTIs with signs of tissue invasion (54.8%), indwelling catheter‐associated UTIs (37.5%), and UTIs in men (29.2%). Although this is considered inadequate, non‐specific symptoms were associated with antibiotic prescription for suspected UTIs in Dutch nursing home residents and nitrofurantoin was inadequately prescribed in particular groups, such as men.
KW - Antibiotic prescribing
KW - Nursing homes
KW - Urinary tract infection
UR - http://www.scopus.com/inward/record.url?scp=85123245856&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/antibiotics11020140
DO - https://doi.org/10.3390/antibiotics11020140
M3 - Article
C2 - 35203742
SN - 2079-6382
VL - 11
JO - Antibiotics
JF - Antibiotics
IS - 2
M1 - 140
ER -