Senthinathan Arrani, Craven B Catherine, Morris Andrew M, Penner Melanie, Tu Karen, Jaglal Susan B
Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada.
KITE (Knowledge Innovation Talent Everywhere), Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada.
Spinal Cord. 2023 Jun;61(6):345-351. doi: 10.1038/s41393-023-00899-x. Epub 2023 May 2.
A retrospective cohort study.
To describe antibiotic prescribing and urine culture testing patterns for urinary tract infections (UTIs) in a primary care Spinal Cord Injury (SCI) cohort.
A primary care electronic medical records (EMR) database in Ontario.
Using linked EMR health administrative databases to identify urine culture and antibiotic prescriptions ordered in primary care for 432 individuals with SCI from January 1, 2013 to December 31, 2015. Descriptive statistics were conducted to describe the SCI cohort, and physicians. Regression analyses were conducted to determine patient and physician factors associated with conducting a urine culture and class of antibiotic prescription.
The average annual number of antibiotic prescriptions for UTI for the SCI cohort during study period was 1.9. Urine cultures were conducted for 58.1% of antibiotic prescriptions. Fluroquinolones and nitrofurantoin were the most frequently prescribed antibiotics. Male physicians and international medical graduates were more likely to prescribe fluroquinolones than nitrofurantoin for UTIs. Early-career physicians were more likely to order a urine culture when prescribing an antibiotic. No patient characteristics were associated with obtaining a urine culture or antibiotic class prescription.
Nearly 60% of antibiotic prescriptions for UTIs in the SCI population were associated with a urine culture. Only physician characteristics, not patient characteristics, were associated with whether or not a urine culture was conducted, and the class of antibiotic prescribed. Future research should aim to further understand physician factors with antibiotic prescribing and urine culture testing for UTIs in the SCI population.
一项回顾性队列研究。
描述初级保健脊髓损伤（SCI）队列中尿路感染（UTI）的抗生素处方和尿培养检测模式。
安大略省的一个初级保健电子病历（EMR）数据库。
利用关联的EMR健康管理数据库，识别2013年1月1日至2015年12月31日期间432例SCI患者在初级保健中开出的尿培养和抗生素处方。进行描述性统计以描述SCI队列和医生情况。进行回归分析以确定与进行尿培养和抗生素处方类别相关的患者和医生因素。
研究期间，SCI队列中UTI的平均每年抗生素处方数为1.9。58.1%的抗生素处方进行了尿培养。氟喹诺酮类和呋喃妥因是最常开具的抗生素。男性医生和国际医学毕业生在治疗UTI时比开具呋喃妥因更倾向于开具氟喹诺酮类。早期职业医生在开具抗生素时更有可能进行尿培养。没有患者特征与进行尿培养或抗生素类别处方相关。
SCI人群中近60%的UTI抗生素处方与尿培养相关。只有医生特征而非患者特征与是否进行尿培养以及所开抗生素类别相关。未来的研究应旨在进一步了解医生在SCI人群中开具UTI抗生素处方和进行尿培养检测的因素。
