Errores de interpretación y tratamientos innecesarios | 07 JUL 14

Análisis de orina en emergencias

Solicitar análisis de orina sin una indicación específica promueve la errónea interpretación de sus resultados y los tratamientos innecesarios con antibióticos debido a la alta prevalencia de la bacteriuria asintomática y otros factores.
Autor/a: Daniel J. Pallin, Clare Ronan, Kamaneh Montazeri, Katherine Wai, Allen Gold, Siddharth Parmar, Jeremiah D. Schuur Fuente: Open Forum Infect Dis (Spring 2014) 1 (1): doi: 10.1093/ofid/ofu019 Urinalysis in Acute Care of Adults: Pitfalls in Testing and Interpreting Results
INDICE:  1.  | 2. Referencias
Referencias
  1. Nicolle LE, Bradley S, Colgan R, et al Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis 2005;40:643-54.  

  2. Bartlett JG A call to arms: the imperative for antimicrobial stewardship. Clin Infect Dis 2011;53(Suppl 1):S4-7.  
  3.  Gross PA, Patel B Reducing antibiotic overuse: a call for a national performance measure for not treating asymptomatic bacteriuria. Clin Infect Dis 2007;45:1335-7.  
  4. Zabarsky TF, Sethi AK, Donskey CJ. Sustained reduction in inappropriate treatment of asymptomatic bacteriuria in a long-term care facility through an educational intervention. Am J Infect Control 2008;36:476-80.
  5. Linares LA, Tornton DJ, Strymish J, et al.Electronic memorandum decreases unnecessary antimicrobial use for asymptomatic bacteriuria and culture-negative pyuria. Infect Control Hosp Epidemiol 2011;32:644-8. 
  6. Loeb M, Brazil K, Lohfeld L, et al Effect of a multifaceted intervention on number of antimicrobial prescriptions for suspected urinary tract infections in residents of nursing homes: cluster randomised controlled trial. BMJ 2005;331:669.
  7.  Samore MH, Bateman K, Alder SC, et al. Clinical decision support and appropriateness of antimicrobial prescribing: a randomized trial. JAMA 2005;294:2305-14.  
  8. Gordon LB, Waxman MJ, Ragsdale L, et al. Overtreatment of presumed urinary tract infection in older women presenting to the emergency department. J Am Geriatr Soc 2013;61:788-92.   
  9. May L, Cosgrove S, L'Archeveque M, et al. A call to action for antimicrobial stewardship in the emergency department: approaches and strategies. Ann Emerg Med 2013;62:69-77.e2.   
  10. Khawcharoenporn T, Vasoo S, Ward E, et al. Abnormal urinalysis finding triggered antibiotic prescription for asymptomatic bacteriuria in the ED. Am J Emerg Med 2011;0:828-30.&nbs
 

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