J Am Pharm Assoc (2003). 2024 May-Jun;64(3):102020. doi: 10.1016/j.japh.2024.01.016. Epub 2024 Feb 1.
Patients with urinary tract infections (UTIs) may have treatment initiated in the emergency department (ED) before discharge with an antibiotic prescription. The effect of a single antibiotic dose administered before discharge on ED length of stay (LOS) is unknown.
The purpose of this study was to compare the LOS and the rate of revisits within 30 days among patients diagnosed as having UTIs other than pyelonephritis who received parenteral, oral, or no antibiotic during an ED visit.
This was a retrospective cohort study of adult patients with a diagnosis of UTI who received an antibiotic prescription at discharge from a single community ED in the United States between 2019 and 2020. Patients were excluded if they were admitted to the hospital, were diagnosed as having pyelonephritis, or had an ED visit in the previous 30 days. ED LOS was compared using 3-factor analysis of variance. ED revisits at 72 hours and 30 days were compared using the chi-square test.
A total of 694 patients with an ED visit for UTI and an antibiotic prescription at discharge were included. The mean age of the study population was 58 years. Parenteral antibiotic administration in the ED was associated with a 60-minute increase in ED LOS compared with those who received an oral antibiotic (P < 0.001) and a 30-minute increase in ED LOS compared with no antibiotic (P < 0.001). No differences were observed in revisits to the ED at 72 hours (5%, 5%, 2%; P = 0.17) or 30 days (15%, 16%, 17%: P = 0.98) among patients who received parenteral, oral, or no antibiotic before discharge.
A single dose of parenteral antibiotic before discharge was associated with an increased ED LOS compared with treatment with oral antibiotic or discharge without ED treatment. ED revisit rates were similar regardless of ED treatment.
患有尿路感染（UTI）的患者在出院前可能会在急诊科（ED）开始接受抗生素治疗。在出院前给予单剂量抗生素对 ED 住院时间（LOS）的影响尚不清楚。
本研究旨在比较接受静脉、口服或无抗生素治疗的非肾盂肾炎性 UTI 患者在 ED 就诊期间的 LOS 和 30 天内再就诊率。
这是一项回顾性队列研究，纳入了 2019 年至 2020 年期间在美国单一社区 ED 就诊并在出院时开具抗生素处方的成人 UTI 患者。排除住院、诊断为肾盂肾炎或在过去 30 天内有 ED 就诊的患者。使用三因素方差分析比较 ED LOS。使用卡方检验比较 72 小时和 30 天的 ED 再就诊。
共纳入 694 例 ED 就诊并开具抗生素处方的 UTI 患者。研究人群的平均年龄为 58 岁。与接受口服抗生素相比，ED 给予静脉抗生素与 ED LOS 增加 60 分钟相关（P<0.001），与不给予抗生素相比，ED LOS 增加 30 分钟（P<0.001）。在接受静脉、口服或无抗生素治疗的患者中，在 72 小时（5%、5%、2%；P=0.17）或 30 天（15%、16%、17%：P=0.98）再就诊 ED 的情况无差异。
与口服抗生素治疗或不给予 ED 治疗相比，在出院前给予单剂量静脉抗生素与 ED LOS 增加相关。无论 ED 治疗如何，ED 再就诊率相似。
