{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T10:33:23Z","timestamp":1725273203262},"reference-count":56,"publisher":"American Society of Consultant Pharmacists","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["sr care pharm"],"published-print":{"date-parts":[[2022,6,1]]},"abstract":"<jats:p><jats:bold>Objective<\/jats:bold> To devise a residential empiric treatment algorithm, describe common uropathogens associated with urinary tract infections (UTIs) in residential care, assess all-pathogen and non-ESBL (extended-spectrum beta-lactamase) Escherichia coli antibiotic susceptibilities,\n and report the percentage of antibiotic use.  <jats:bold>Design<\/jats:bold> A retrospective chart review of 198 residents with positive urine cultures from September 2019 to September 2020.  <jats:bold>Setting<\/jats:bold> Institutional long-term care facility.  <jats:bold>Participants<\/jats:bold> The\n exclusion criteria were negative urine culture, mixed organisms on urine culture, no antibiotic treatment, signs and symptoms of systemic infection, hospitalization because of systemic infection, and intravenous antibiotic treatment. The entire population was screened.  <jats:bold>Results<\/jats:bold>\n The most prevalent pathogens were non-ESBL E. coli (29%), Proteus mirabilis (12%), Klebsiella pneumoniae (8%), and ESBL <jats:italic>E.<\/jats:italic> coli (8%). All-pathogen susceptibilities were 79.6% (amoxicillin\/clavulanate), 64.1% (nitrofurantoin), 50.5% (sulfamethoxazole\/trimethoprim), 43.7% (cephalexin),\n 42.7% (amoxicillin), and 41.8% (ciprofloxacin). Amoxicillin\/clavulanate (96.7%), nitrofurantoin (90.0%) and sulfamethoxazole\/trimethoprim (83.3%) demonstrated the highest non-ESBL <jats:italic>E. coli<\/jats:italic> susceptibilities. Nitrofurantoin was the most prescribed antibiotic (21%), followed by amoxicillin\/clavulanate\n (19%) and ciprofloxacin (17%).  <jats:bold>Conclusion<\/jats:bold> Based on the data, amoxicillin\/clavulanate and nitrofurantoin are appropriate first-line options for empiric treatment of symptomatic cystitis in this long-term care facility, with sulfamethoxazole\/trimethoprim as an alternative.\n Ciprofloxacin was overprescribed despite its low susceptibilities to commonly encountered pathogens, which emphasizes the need for a UTI empiric treatment algorithm tailored towards residential care.<\/jats:p>","DOI":"10.4140\/tcp.n.2022.232","type":"journal-article","created":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T04:38:02Z","timestamp":1653453482000},"page":"232-243","source":"Crossref","is-referenced-by-count":3,"title":["Urinary Tract Infections in Long-term Care: Evaluation of Uropathogens, Antibiotic Susceptibility, and Empiric Treatment"],"prefix":"10.4140","volume":"37","author":[{"given":"Winnie","family":"Bao","sequence":"first","affiliation":[{"name":"1University of British Columbia, Vancouver, British Columbia, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mira","family":"Koro","sequence":"additional","affiliation":[{"name":"1University of British Columbia, Vancouver, British Columbia, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel W.","family":"Loh","sequence":"additional","affiliation":[{"name":"1University of British Columbia, Vancouver, British Columbia, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Ortiz","sequence":"additional","affiliation":[{"name":"1University of British Columbia, Vancouver, British Columbia, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2625","reference":[{"issue":"3","key":"ref1","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1086\/313996","article-title":"Urinary tract infection in long-term-care facility residents.","volume":"31","year":"2000","journal-title":"Arch Clin Infect Dis."},{"key":"ref2","article-title":"From Residential Care to the Hospital: A Pattern Emerges.","year":"2018"},{"key":"ref3","article-title":"Guidelines for the Prevention and Treatment of Urinary Tract Infections (UTIs) in Continuing Care Settings.","year":"2014"},{"key":"ref4","volume-title":"Fluoroquinolone prescribing and use in Canadian primary care practice [internet].","year":"2017"},{"issue":"1","key":"ref5","first-page":"12","article-title":"Diagnosis, treatment, and prevention of urinary tract infections in post-acute and long-term care settings: a consensus statement from AMDA's Infection Advisory Subcommittee.","volume":"21","year":"2020","journal-title":"JAMDA."},{"key":"ref6","year":"2020","journal-title":"Spectrum\u2013Clinical Decisions."},{"key":"ref7","year":"2020","journal-title":"App Store"},{"key":"ref8","article-title":"Urinary Tract Infections (UTI) in Older Adults.","year":"2019"},{"key":"ref9","article-title":"Urinary Tract Infections in Primary Care and Long-Term Care.","year":"2020"},{"issue":"12","key":"ref10","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1097\/JXX.0000000000000204","article-title":"Does treatment of urinary tract infections reflect the antibiotic stewardship program guidelines?.","volume":"31","year":"2019","journal-title":"J Am Assoc Nurse Pract."},{"issue":"6","key":"ref11","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1016\/j.gerinurse.2012.05.003","article-title":"Long-Term care acquired urinary tract infections' antibiotic resistance patterns and empiric therapy: a pilot study.","volume":"33","year":"2012","journal-title":"Geriatr Nurs."},{"key":"ref12","first-page":"2020","article-title":"Management of urinary tract infections (UTIs) in non-catheterized long-term care home residents.","year":"2018"},{"key":"ref13","article-title":"Best Practices for Surveillance of Health Care-Associated Infections.","year":"2008"},{"key":"ref14","article-title":"Bladder Dysfunction in Multiple Sclerosis.","year":"2021"},{"issue":"5","key":"ref15","first-page":"e103","article-title":"International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases.","volume":"52","journal-title":"Arch Clin Infect Dis."},{"key":"ref16","article-title":"VCH Management of Urinary Tract Infections (UTI) in Non-pregnant Adults."},{"key":"ref17","article-title":"Urinary Tract Infections (UTI).","year":"2019"},{"key":"ref18","article-title":"Urinary Tract Infection.","year":"2019","journal-title":"Therapeutics."},{"key":"ref19","article-title":"Restricted Drugs at Vancouver Community of Care.","year":"2020"},{"key":"ref20","article-title":"Urinary Tract Infection. 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