1308 - Reducing Asymptomatic Bacteriuria Treatment – a Collaborative Approach

Session Description: Urinary tract infections (UTI) are the most commonly identified infections in both the inpatient and outpatient settings, however, appropriate diagnosis and management remain challenging. Patients with positive urine cultures and no clinical symptoms of a UTI - asymptomatic bacteriuria (ASB) - are often prescribed unnecessary antibiotics. As an effort to improve unnecessary identification of ASB and optimize treatment of UTIs, in 2020 the multidisciplinary Antimicrobial Stewardship Committee proposed and received approval for a UTI treatment bundle that included targeted improvements for both diagnosis and treatment of UTIs in the hospital. Infection Prevention and Antimicrobial Stewardship further collaborated with laboratory services and quality/patient safety to develop questions tied to urinalysis (UA) with reflex to culture orders that would help guide appropriateness of collection of urinary cultures.

After implementation in hospitalized patients, attention was turned to patients residing in the community. The Antimicrobial Stewardship Committee worked in collaboration with outpatient leadership to implement similar questions to outpatient UA with reflex to culture orders. The team also worked to restrict ordering of standalone urine cultures to providers serving patients in which ASB should be treated. Infection Prevention and Antimicrobial Stewardship evaluated data in patients’ charts for compliance. This information is being utilized to improve patient outcomes and reduce antimicrobial resistance, while increasing collaboration amongst multiple stakeholders.