Mismatch between suspected Pyelonephritis and microbiological diagnosis: a cohort study from a UK teaching hospital.


Shallcross, L; Gaskell, K; Fox-Lewis, A; Bergstrom, M; Noursadeghi, M; (2017) Mismatch between suspected Pyelonephritis and microbiological diagnosis: a cohort study from a UK teaching hospital. The Journal of hospital infection. ISSN 0195-6701 DOI: https://doi.org/10.1016/j.jhin.2017.09.029

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Abstract

Urinary tract infection (UTI) syndromes are a common reason for empirical antibiotic prescribing in the Emergency Department (ED). We investigated the role of microbiological culture and urinalysis in the diagnosis of pyelonephritis by extracting data on 105 patients with a clinical diagnosis of pyelonephritis at a London teaching hospital. 96/102 patients were treated empirically with intravenous antibiotics but only 55/100 patients who were sampled had microbiological evidence of infection in urine and/or blood. Almost half (10/21) of patients with a negative urine dipstick test had a positive urine culture. Diagnostic uncertainty in this context undoubtedly drives inappropriate antibiotic use.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
PubMed ID: 28987639
URI: http://researchonline.lshtm.ac.uk/id/eprint/4511124

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