TY  - JOUR
AU  - Fésüs, Adina
AU  - Matuz, Mária
AU  - Papfalvi, Erika Piroska
AU  - Hambalek, Helga
AU  - Ruzsa, Roxána
AU  - Tánczos, Bence
AU  - Bácskay, Ildikó
AU  - Lekli, István
AU  - Illés, Árpád
AU  - Benkő, Ria
TI  - Evaluation of the Diagnosis and Antibiotic Prescription Pattern in Patients Hospitalized with Urinary Tract Infections: Single-Center Study from a University-Affiliated Hospital
JF  - ANTIBIOTICS
J2  - ANTIBIOTICS-BASEL
VL  - 12
PY  - 2023
IS  - 12
PG  - 19
SN  - 2079-6382
DO  - 10.3390/antibiotics12121689
UR  - https://m2.mtmt.hu/api/publication/34413320
ID  - 34413320
N1  - Department of Pharmacology, Faculty of Pharmacy, University of Debrecen, Debrecen, H-4032, Hungary            
            Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Debrecen, Debrecen, H-4032, Hungary            
            Institute of Healthcare Industry, University of Debrecen, Debrecen, H-4032, Hungary            
            Clinical Pharmacy Department, Faculty of Pharmacy, University of Szeged, Szeged, H-6725, Hungary            
            Central Pharmacy, Albert Szent Györgyi Medical Center, University of Szeged, Szeged, H-6725, Hungary            
            Department of Emergency Medicine, Albert Szent Györgyi Medical Center, University of Szeged, Szeged, H-6725, Hungary            
            Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, H-4032, Hungary            
            Cited By :1            
            Export Date: 3 May 2024            
            Correspondence Address: Benkő, R.; Clinical Pharmacy Department, Hungary; email: benko.ria@med.u-szeged.hu            
            Chemicals/CAS: amikacin, 37517-28-5, 39831-55-5, 110660-83-8, 1257517-67-1; amoxicillin, 26787-78-0, 34642-77-8, 61336-70-7; amoxicillin plus clavulanic acid, 74469-00-4, 79198-29-1; cefotaxime, 63527-52-6, 64485-93-4; ceftazidime, 72558-82-8, 73547-61-2, 78439-06-2; ceftriaxone, 73384-59-5, 74578-69-1, 104376-79-6; cefuroxime, 55268-75-2, 56238-63-2; cilastatin, 81129-83-1, 82009-34-5; cilastatin plus imipenem, 92309-29-0; ciprofloxacin, 85721-33-1, 86393-32-0, 128074-72-6, 128074-76-0, 192934-52-4, 93107-08-5, 86483-48-9, 96186-80-0; clarithromycin, 81103-11-9; clavulanic acid, 58001-44-8; cotrimoxazole, 8064-90-2; fosfomycin, 23155-02-4; gentamicin, 1392-48-9, 1403-66-3, 1405-41-0; imipenem, 64221-86-9; levofloxacin, 100986-85-4, 138199-71-0; meropenem, 96036-03-2; metronidazole, 39322-38-8, 443-48-1, 69198-10-3; moxifloxacin, 151096-09-2, 186826-86-8; nitrofurantoin, 54-87-5, 67-20-9; norfloxacin, 70458-96-7; ofloxacin, 82419-36-1; piperacillin plus tazobactam, 157044-21-8; trometamol, 1185-53-1, 77-86-1            
            Funding details: NKFI-143360, TKP2021-EGA-32            
            Funding details: TKP2021-EGA-18            
            Funding details: European Commission, EC            
            Funding details: European Regional Development Fund, ERDF, GINOP-2.3.4-15-2020-00008            
            Funding details: Nemzeti Kutatási, Fejlesztési és Innovaciós Alap, NKFIA            
            Funding text 1: This work has been implemented with support provided by the Ministry of Innovation and Technology of Hungary from the National Research, Development and Innovation Fund, financed by ITM NKFIA TKP2021-EGA-32, and NKFI-143360. The project is co-financed by the European Union and the European Regional Development Fund by GINOP-2.3.4-15-2020-00008. The research was also supported by the Thematic Excellence Program (TKP2021-EGA-18) of the Ministry for Innovation and Technology in Hungary.
AB  - UTIs (urinary tract infections) are common bacterial infections with a non-negligible hospitalization rate. The diagnosis of UTIs remains a challenge for prescribers and a common source of misdiagnosis. This retrospective observational study aimed to evaluate whether recorded diagnosis by clinicians and empirical antibiotic therapy met the EAU (European Association of Urology) guideline in patients hospitalized with UTI. The study was conducted at an internal medicine unit of a tertiary care medical center in Hungary. The diagnosis was assessed based on clinical presentation, physical examination, and laboratory (including microbiological) results, considering all the potential risk factors. Diagnosis was considered misdiagnosis when not confirmed by clinical presentation or clinical signs and symptoms. Evaluation of empirical antibiotic therapy was performed only for confirmed UTIs. Empirical treatment was considered guideline-adherent when complying with the relevant recommendations. Out of 185 patients, 41.6% failed to meet EAU-based UTI diagnosis criteria, of which 27.6% were misdiagnosed and 14.1% were ABU (asymptomatic bacteriuria). The diagnosis of urosepsis recorded at admission (9.7%, 18/185) was not confirmed either by clinical or microbiological tests in five (5/18) cases. The initial empirical therapies for UTI showed a relatively low rate (45.4%) of guideline adherence regarding agent selection. The most common guideline-non-adherent therapies were combinations with metronidazole (16.7%). Dosage appropriateness assessments showed a guideline adherence rate of 36.1%, and underdosing due to high body weight was common (9.3%). Overall (agent, route of administration, dose, duration) guideline adherence was found to be substantially low (10.2%). We found a relatively high rate of misdiagnosed UTIs. Written protocols on the ward may be crucial in reducing misdiagnosis and in optimizing antibiotic use.
LA  - English
DB  - MTMT
ER  -