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Alghamdi A, Alkazemi A, Ibrahim A, Alraey M, Alaboud M, Farooqi I, Aatif Khan M, Allam A, Alwadai M, Alyahya R, Alzahrani O, Alqhatani H, Mohareb A, Aleissa M
Impact of Diagnostic Stewardship on Urine Culture Ordering in Saudi Arabia: Prospective Pre- and Postintervention Study
Impact of Diagnostic Stewardship on Urine Culture Ordering in Saudi Arabia: A Prospective Pre- and Post-Intervention Study
Ahlam Alghamdi;
Afrah Alkazemi;
Alnada Ibrahim;
Mohammed Alraey;
Mohammed Alaboud;
Isra Farooqi;
Mohammad Aatif Khan;
Asem Allam;
Mohammed Alwadai;
Renad Alyahya;
Ohoud Alzahrani;
Hajar Alqhatani;
Amir Mohareb;
Muneerah Aleissa
ABSTRACT
Background:
Inappropriate testing of urine cultures can lead to overuse of antibiotics, antimicrobial resistance, Clostridioides difficile infections, and increased cost.
Objective:
We assessed the implementation of a clinical decision support (CDS) tool in diagnostic stewardship, focusing on the appropriateness of urine culture orders and antibiotic utilization.
Methods:
We examined differences in urine culture testing and antibiotics utilization before and after implementation of a CDS tool in a 400-bed hospital in Riyadh, Saudi Arabia, from August 2021 to July 2022. We included adult patients with urine culture orders. Our outcomes were the inappropriate urine cultures ordered and antibiotic utilization after the implementation of CDC intervention. We used multivariable logistic regression model to determine factors associated with inappropriate urine culture testing and antibiotic use.
Results:
Inappropriate urine culture orders were significantly lower in the post-intervention period compared to the pre-intervention period (36.4% vs. 41.6% p = 0.001). The CDS intervention was associated with 16.7% lower odds of inappropriate urine culture ordering (adjOR 0.83; 95%CI 0.73 – 0.95; p = 0.008). Unnecessary antibiotics were significantly lower in the post-intervention period (72.9% v 85.7%, p <0.0001). The CDS intervention was associated with 52% reduction in unnecessary antibiotic use (aOR 0.487; 95% CL 0.332–0.713, p = <0.000)
Conclusions:
A CDS initiative can reduce unnecessary urine culture testing and antibiotic overuse.
Citation
Please cite as:
Alghamdi A, Alkazemi A, Ibrahim A, Alraey M, Alaboud M, Farooqi I, Aatif Khan M, Allam A, Alwadai M, Alyahya R, Alzahrani O, Alqhatani H, Mohareb A, Aleissa M
Impact of Diagnostic Stewardship on Urine Culture Ordering in Saudi Arabia: Prospective Pre- and Postintervention Study