Amenta Eva M, Jump Robin L P, Trautner Barbara W
Center for Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey Veterans' Affairs Medical Center, Houston, Texas.
Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, Texas.
Antimicrob Steward Healthc Epidemiol. 2023 Jan 9;3(1):e4. doi: 10.1017/ash.2022.343. eCollection 2023.
The evidence base for refraining from screening for or treating asymptomatic bacteriuria (ASB) in older adults is strong, but both practices remain prevalent. Clinical confusion over how to respond to a change from baseline, when to order a urinalysis and urine culture, and what to do with a positive urine culture fuels unnecessary antibiotic use for ASB. If the provider can take a mindful pause to apply evidenced-based assessment tools, the resulting increased clarity in how to manage the situation can reduce overtreatment of ASB.
不建议对老年人进行无症状菌尿(ASB)筛查或治疗的证据很充分,但这两种做法仍然普遍存在。对于如何应对与基线水平的变化、何时进行尿液分析和尿培养以及对阳性尿培养结果如何处理,临床上存在困惑,这导致了对ASB不必要的抗生素使用。如果医疗服务提供者能够有意识地停下来应用循证评估工具,那么在如何处理这种情况上所获得的清晰度提高,就可以减少对ASB的过度治疗。