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De-implementation strategy to reduce overtreatment of asymptomatic bacteriuria: the ROAB-study

Completed
Conditions
Asymptomatic bacteriuria is the presence of bacteria in the urine of a patient, who does not have symptoms of urinary tract infection (UTI). This is a common finding especially among women, elderly persons, and patients with urinary catheters. Guidelines strongly recommend not to screen for or treat asymptomatic bacteriuria with antimicrobials, except for specific patients at risk of developing a complicated UTI.
Registration Number
NL-OMON25918
Lead Sponsor
Amsterdam UMC, location AMC
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Completed
Sex
Not specified
Target Recruitment
420
Inclusion Criteria

Our target size is at least 420 patients.
Patients =18 years old who had urine tests (culture and/or urinalysis), that were obtained during presentation at the emergency department will be screened for eligibility.

Exclusion Criteria

-Negative urinalysis and negative urine cultures
-Patients with symptomatic UTI
-Patients with an alternate site of infection for which they receive antimicrobial treatment
-Patients with ASB and risk factors, defined as pregnant women, patients prior to planned invasive urologic procedures associated with mucosal trauma (including transurethral surgery of the prostate or bladder, ureteroscopy including lithotripsy, and percutaneous stone surgery), and high-risk neutropenia (defined as absolute neutrophil count <500 cells/µl).

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
The percentage of patients with ASB without risk factors or other alternative site of infections who are treated with antimicrobials.
Secondary Outcome Measures
NameTimeMethod
The duration of antimicrobial treatment for ASB, the number of urine cultures per 1000 patients at the emergency department, the number of urinalysis (dipsticks and microscopic analysis), incorrect treatment of patients with urine cultures that are in daily practice considered positive with a quantitative count of bacteria =10^3 CFU/ml, and the percentage of patients treated with antimicrobials for a positive urinalysis without symptoms or risk factors as stated above. In addition, the total number of urine cultures ordered in the hospital will be assessed explorative. Furthermore, the indications for the negative urine cultures will be assessed explorative<br>during the baseline period.
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