Expanded UTI definitions could reduce inappropriate antibiotic use

A recent study shows that many patients receiving antibiotics for urinary tract infections (UTIs) may not need them. The study focused on asymptomatic bacteriuria (ASB), a condition where bacteria are present in urine without symptoms. Researchers suggest that a new definition, asymptomatic pyuria and/or nitrituria (ASPN), might help better identify unnecessary antibiotic use. The study examined 249 patients and found that 222 cases had ASPN, while 133 had ASB as defined by traditional standards. ASPN identified 40% more instances of unnecessary antibiotic prescribing compared to the ASB definition. This indicates that ASPN is a more effective marker for spotting inappropriate use of antibiotics. Whitney Hartlage, a clinical pharmacist involved in the study, highlighted that the current ASB definition has limitations. It only considers patients with high levels of bacteria, potentially missing those who still need treatment but do not meet this criterion. The reliance on urinalysis results for diagnosing UTIs contributes to the overuse of antibiotics. Hartlage noted that many healthcare providers depend too much on these test results without considering patients' symptoms, which can lead to unnecessary treatment. To improve antibiotic stewardship, the study recommends incorporating ASPN into clinical practice. This would help reduce unnecessary tests and improve education on interpreting urinalysis results. Hartlage emphasized that updating definitions and methods is crucial for controlling antibiotic overuse in UTI treatment.