Which patient should start empirical antibiotic treatment in urinary tract infection in emergency departments?

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dc.contributor.authorBaşer, Aykut
dc.contributor.authorYılmaz, Atakan
dc.contributor.authorBaşer, Hülya Yılmaz
dc.contributor.authorÖzlülerden, Yusuf
dc.contributor.authorZümrütbaş, Ali Ersin
dc.date.accessioned2021-11-01T15:05:01Z
dc.date.available2021-11-01T15:05:01Z
dc.date.issued2020
dc.departmentHitit Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü
dc.description.abstractOBJECTIVES: This study aims to determine the factors that would lead the doctors in EDs to a more the accurate diagnosis of urinary tract infection (UTI) and the correct initiation of empirical antibiotherapy in the emergency room and reduce the use of unnecessary antibiotherapy. METHODS: This study is a prospective observational study from a single-center, investigating patients with an age of 18 years and older who presented to the emergency department (ED) with the symptoms of UTI between January and May 2018. The guiding parameters to establish a UTI diagnosis and start an empirical antibiotherapy were investigated between the negative (Group 1) and positive (>103 colonies) (Group 2) groups, as a result of urine culture in terms of urine culture. RESULTS: Our study included a total of 108 patients (59 women and 49 men). The average age was 47.11 +/- 14.97. Age and gender were similar among the groups and not a discriminating factor in the diagnosis of UTI. High Charlson Comorbidity Index score, history of chronic kidney failure and cerebrovascular disease, leukocyte esterase, nitrite positivity, and leukocyte cluster presence were higher in Group 2. We suggest that these parameters might be predictive values to detect bacterial growth in urine culture. Empirical antibiotherapy was started in 48.4% of the patients in Group 1 and 95.7% of the patients in Group 2. CONCLUSIONS: In EDs, admission complaints of the patients and physical examination findings do not always result in the diagnosis of UTI. Our study showed that UTI diagnosis could be made more accurately using leukocyte esterase, nitrite positivity, the presence of leukocyte clusters, and the Charlson Comorbidity Index score. We also suggest that regional antibiotic resistance should be considered before starting empirical antibiotherapy.
dc.identifier.citationBaşer, A., Yilmaz, A., Başer, H. Y., Özlülerden, Y., & Zümrütbaş, A. E. (2020). Which patient should start empirical antibiotic treatment in urinary tract infection in emergency departments?. Turkish Journal of Emergency Medicine, 20(3), 111.
dc.identifier.doi10.4103/2452-2473.290064
dc.identifier.endpage117en_US
dc.identifier.issn2452-2473
dc.identifier.issue3en_US
dc.identifier.pmid32832730
dc.identifier.scopus2-s2.0-85090655662
dc.identifier.scopusqualityQ2
dc.identifier.startpage111en_US
dc.identifier.urihttps://doi.org/10.4103/2452-2473.290064
dc.identifier.urihttps://hdl.handle.net/11491/7051
dc.identifier.volume20en_US
dc.identifier.wosWOS:000556675800003
dc.identifier.wosqualityN/A
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorBaşer, Aykut
dc.language.isoen
dc.publisherWolters Kluwer Medknow Publications
dc.relation.ispartofTurkish Journal Of Emergency Medicine
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectEmergency departmenten_US
dc.subjectEmpirical antibiotherapyen_US
dc.subjectUrinary tract infectionen_US
dc.titleWhich patient should start empirical antibiotic treatment in urinary tract infection in emergency departments?
dc.typeArticle

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