Relieving the Burn: Pharmacists improve the use of antibiotics in the emergency department for urinary tract infections

About the Program

Category: Health (Best in Category)

Year: 2021

Many people seek help in emergency departments for urinary tract infections. But, studies have found that antibiotics are used incorrectly about 30-40% of the time. One reason for this is that urine cultures taken during the emergency department visit can take several days to process. If too many antibiotics are used when they are not needed, or not enough is given when needed, this can cause the bacteria in the local community to change and infections to become harder to treat with the usual antibiotics. We noticed that the follow up on urinary tract infections treated at our emergency department could be improved. In 2020, we started a new process where pharmacists reviewed all urine cultures from the emergency department that were processed as positive. We tracked whether changes were made to the antibiotics that were ordered and how long it took to make changes. Then we compared our old process with our new process. When pharmacists reviewed urine cultures, more appropriate changes were made to antibiotics. Pharmacists were able to follow-up about 1 day faster and patients took shorter courses of antibiotics, saving patients 64 days of antibiotics over a 2-month time frame. We were able to do this without causing patients to come back to the emergency department more often. On top of lowering the amount of antibiotics used for urinary tract infections, we also taught better technique for taking urine samples, posted new signs in our restrooms, and made materials to help doctors in the emergency department pick the best antibiotic.