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.
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.
Bartlett JG A call to arms: the imperative for antimicrobial stewardship. Clin Infect Dis 2011;53(Suppl 1):S4-7.
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.
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.
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.
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.
Samore MH, Bateman K, Alder SC, et al. Clinical decision support and appropriateness of antimicrobial prescribing: a randomized trial. JAMA 2005;294:2305-14.
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.
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.
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