Uti audit l.jpg
This presentation is the property of its rightful owner.
Sponsored Links
1 / 15

UTI Audit PowerPoint PPT Presentation


  • 357 Views
  • Uploaded on
  • Presentation posted in: General

UTI Audit. Alice Lawton GP ST3. My Audit. Patients aged >65yrs Treated for suspected/proven UTI in January 2011 Looked at choice of antibiotic, treatment length and whether MSU sent. Results. 19 patients 13F 6M Average age 78. Choice of Antibiotic. Treatment Duration. Local Guidelines.

Download Presentation

UTI Audit

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Uti audit l.jpg

UTI Audit

Alice Lawton

GP ST3


My audit l.jpg

My Audit

  • Patients aged >65yrs

  • Treated for suspected/proven UTI in January 2011

  • Looked at choice of antibiotic, treatment length and whether MSU sent


Results l.jpg

Results

  • 19 patients

  • 13F 6M

  • Average age 78


Choice of antibiotic l.jpg

Choice of Antibiotic


Treatment duration l.jpg

Treatment Duration


Local guidelines l.jpg

Local Guidelines

  • Trimethoprim 200mg BD

    OR

  • Nitrofurantoin 50mg QDS

    For 7 days


Our practice l.jpg

Our Practice

  • High use of cefalexin

  • Against guidelines

  • Broad spectrum antibiotics

    • Increased incidence C. Difficile

    • MRSA

    • Future resistant UTIs


Msu sent l.jpg

MSU Sent?


Local guidelines9 l.jpg

Local Guidelines

  • Send MSUs for all >65

  • Also all men, pregnant women, children, recurrent infections and failure of treatment


Quick reminder other uti l.jpg

Quick Reminder Other UTI

  • Uncomplicated UTI<65yr

    • Trimethoprim 200mg BD or Nitrofurantoin 50mg QDS - 3 days

  • Men/recurrence/failure -

    • as per >65yrs

  • Pregnant women

    • Cefalexin 500mg BD or Amoxicillin 500mg TDS - 7 days

  • Children

    • Trimethoprim/nitrofurantoin/cefalexin - dose as per child - 7 days


Catheterised patients l.jpg

Catheterised Patients

  • Routine CSU not indicated

  • Do not use CSU/dipstick to diagnose

  • Clinical basis - sx UTI

  • Send CSU if sx

  • Change long term catheter before treatment

  • Choose abx from CSU if poss (trimethoprim/nitrofurantoin 7D if not)

  • Take into account prev CSU results

  • Review antibiotic

  • Antibiotic prophylaxis not recommended


Acute pyelonephritis l.jpg

Acute Pyelonephritis

  • Send MSU

  • Co-amoxiclav 625mg TDS

    OR

  • Ciprofloxacin 500mg BD

    OR

  • Cefalexin 500mg TDS (if pregnant)

    14 days


Re audit results l.jpg

Re-audit results

  • Correct antibiotic (ie trimethoprim/nitrofurantoin)

    • 76.5% (previously 42%)

  • Correct treatment duration of 7 days

    • 84.6% (prev. 78.9%)

  • MSU sent?

    • 84.6% (prev. 52.6%)

  • Note of the MC&S sent none were resistant to trimethoprim which was cited as a reason for prescribing cefalexin by the clinicians


Conclusion l.jpg

Conclusion

  • Try and avoid broad spectrum abx

  • Trimethoprim and nitrofurantoin are first line in all UTI treatment (apart from pregnant women)

  • Duration 7 days in all but uncomplicated UTIs in women <65yr

  • Send MSU in all but uncomplicated UTIs in women <65yr


Questions l.jpg

Questions?


  • Login