FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W4310478441> ?p ?o ?g. }

• W4310478441 endingPage "ii15" @default.
• W4310478441 startingPage "ii14" @default.
• W4310478441 abstract "Abstract Introduction Across the South Central Antimicrobial Network, trimethoprim is not recommended for empirical UTI treatment due to high levels of local resistance. Despite this, trimethoprim prescribing remains above the national median. Due to antibiotic resistance and the presence of asymptomatic bacteriuria, it is important to safeguard the management of UTI’s for older people, improving both patient outcomes and antimicrobial stewardship. Aim This audit aimed to reduce the inappropriate prescribing of UTI antibiotics for non-catheterised patients over the age of 65 at Ringwood Medical Centre. Standards 100% of Trimethoprim prescriptions for a UTI will be based on cultures or microbiology advice. 100% of over 65’s treated for a UTI should have documented clinical signs and symptoms. 100% of over 65’s treated with an antibiotic for a UTI had MSU sent for cultures and sensitivities. Methods Data was collected and analysed in line with the RCGP TARGET UTI toolkit.1 A retrospective System One patient data search took place between 1st June – 31st August 2021. Search criteria included: ≥ 65 years, non-catheterised, coded/suspected UTI diagnosis, prescription of an indicated UTI antibiotic. Antibiotic prescribing was evaluated in comparison to local2 and national3 guidance. Ethical approval was not required. Preliminary results were presented to the prescribing lead at Ringwood Medical Centre in November 2021 and the search was repeated between 1st December – 28th February 2022. Feedback promoted the implementation of local UTI guidance and was communicated throughout the practice. 15 patients were randomly selected for analysis, sampling 1 patient per 1,000 registered at the medical centre. Results Between June-August, 27% of patients were prescribed the correct antibiotic at the right strength, dose, frequency and duration. This increased to 73% when the search was re-run between December-February. Analysis found duration of treatment as a significant contributor to incorrect prescribing for females prescribed nitrofurantoin. Initially, 0% of trimethoprim prescriptions were based on cultures or microbiology advice. Between December-February no instances of trimethoprim prescribing were observed, as alternative antibiotics had been correctly prescribed. 60% had documented clinical symptoms of a UTI across both time periods. A midstream specimen of urine (MSU) was sent for cultures and sensitivities for 65% of those sampled (June-August), increasing to 73% when reaudited (December-February). Discussion/Conclusion This audit has observed a significant improvement in the management of UTI’s in the over 65’s at Ringwood Medical Centre. When the search was re-run, trimethoprim was no longer prescribed inappropriately, and for females, course lengths of nitrofurantoin were standardised at 3 days in line with current guidance. The audit has since been extended to all practices within the Primary Care Network, promoting improvement across the Clinical Commissioning Group. Additional improvement to ensure the documentation of clinical signs and symptoms is important to ensure the exclusion of red flag criteria upon diagnosis. Limitations of this study include a lack of long term follow up and small sample size. Future work to evaluate the use of non-indicated antibiotics for the management of UTI would prove hugely beneficial, further improving antimicrobial stewardship, patient centred care and pharmacy practice within the local area. References 1. Royal College of General Practitioners. Antibiotic Prescribing in Primary Care UTI Audit for NON-CATHETERISED patients OVER 65. 2021. Available from: https://elearning.rcgp.org.uk/mod/book/view.php?id=12652. 2. SCAN Guidelines. Urinary Tract Infections. 2021. Available from: https://viewer.microguide.global/SCAN/SCAN#content,76dd6f46-e50c-4a9b-ac53-a6b171323561. 3. National Institute for Health and Care Excellence. UTI (lower): Antimicrobial Prescribing. 2018. Available from: https://www.nice.org.uk/guidance/ng109/resources/visual-summary-pdf-6544021069. Pages 2-3." @default.
• W4310478441 created "2022-12-10" @default.
• W4310478441 creator A5023169399 @default.
• W4310478441 creator A5037389387 @default.
• W4310478441 creator A5065222075 @default.
• W4310478441 date "2022-11-30" @default.
• W4310478441 modified "2023-09-27" @default.
• W4310478441 title "Antimicrobial stewardship in general practice – urinary tract infections in the over 65’s" @default.
• W4310478441 doi "https://doi.org/10.1093/ijpp/riac089.016" @default.
• W4310478441 hasPublicationYear "2022" @default.
• W4310478441 type Work @default.
• W4310478441 citedByCount "0" @default.
• W4310478441 crossrefType "journal-article" @default.
• W4310478441 hasAuthorship W4310478441A5023169399 @default.
• W4310478441 hasAuthorship W4310478441A5037389387 @default.
• W4310478441 hasAuthorship W4310478441A5065222075 @default.
• W4310478441 hasBestOaLocation W43104784411 @default.
• W4310478441 hasConcept C126322002 @default.
• W4310478441 hasConcept C177713679 @default.
• W4310478441 hasConcept C178790620 @default.
• W4310478441 hasConcept C185592680 @default.
• W4310478441 hasConcept C187212893 @default.
• W4310478441 hasConcept C2426938 @default.
• W4310478441 hasConcept C2776040555 @default.
• W4310478441 hasConcept C2778512257 @default.
• W4310478441 hasConcept C2780728791 @default.
• W4310478441 hasConcept C4937899 @default.
• W4310478441 hasConcept C501593827 @default.
• W4310478441 hasConcept C71924100 @default.
• W4310478441 hasConcept C77411442 @default.
• W4310478441 hasConcept C86803240 @default.
• W4310478441 hasConcept C89423630 @default.
• W4310478441 hasConcept C94665300 @default.
• W4310478441 hasConcept C98274493 @default.
• W4310478441 hasConceptScore W4310478441C126322002 @default.
• W4310478441 hasConceptScore W4310478441C177713679 @default.
• W4310478441 hasConceptScore W4310478441C178790620 @default.
• W4310478441 hasConceptScore W4310478441C185592680 @default.
• W4310478441 hasConceptScore W4310478441C187212893 @default.
• W4310478441 hasConceptScore W4310478441C2426938 @default.
• W4310478441 hasConceptScore W4310478441C2776040555 @default.
• W4310478441 hasConceptScore W4310478441C2778512257 @default.
• W4310478441 hasConceptScore W4310478441C2780728791 @default.
• W4310478441 hasConceptScore W4310478441C4937899 @default.
• W4310478441 hasConceptScore W4310478441C501593827 @default.
• W4310478441 hasConceptScore W4310478441C71924100 @default.
• W4310478441 hasConceptScore W4310478441C77411442 @default.
• W4310478441 hasConceptScore W4310478441C86803240 @default.
• W4310478441 hasConceptScore W4310478441C89423630 @default.
• W4310478441 hasConceptScore W4310478441C94665300 @default.
• W4310478441 hasConceptScore W4310478441C98274493 @default.
• W4310478441 hasIssue "Supplement_2" @default.
• W4310478441 hasLocation W43104784411 @default.
• W4310478441 hasOpenAccess W4310478441 @default.
• W4310478441 hasPrimaryLocation W43104784411 @default.
• W4310478441 hasRelatedWork W2060355195 @default.
• W4310478441 hasRelatedWork W2072888711 @default.
• W4310478441 hasRelatedWork W2531823323 @default.
• W4310478441 hasRelatedWork W2581299351 @default.
• W4310478441 hasRelatedWork W3002376484 @default.
• W4310478441 hasRelatedWork W3083932983 @default.
• W4310478441 hasRelatedWork W3126333765 @default.
• W4310478441 hasRelatedWork W3176712139 @default.
• W4310478441 hasRelatedWork W4280637011 @default.
• W4310478441 hasRelatedWork W4307878403 @default.
• W4310478441 hasVolume "30" @default.
• W4310478441 isParatext "false" @default.
• W4310478441 isRetracted "false" @default.
• W4310478441 workType "article" @default.