Epidemiology and Public Health, University of Maryland School of Medicine, 10 S. Pine Street, Baltimore, MD 21201, USA.
Department of Practice and Science and Health Outcomes Research, University of Maryland School of Pharmacy, Baltimore, MD, USA.
Infect Dis Clin North Am. 2024 Jun;38(2):255-266. doi: 10.1016/j.idc.2024.03.004. Epub 2024 Apr 4.
Urinary tract infections are among the most common infectious diagnoses in health care, but most urinary tract infections are diagnosed inappropriately in patients without signs or symptoms of infection. Asymptomatic bacteriuria leads to inappropriate antibiotic prescribing and negative downstream effects, including antimicrobial resistance, health care-associated infections, and adverse drug events. Diagnostic stewardship is the process of modifying the ordering, performing, or reporting of test results to improve clinical care. Diagnostic stewardship impacts the diagnostic pathway to decrease inappropriate detection and treatment of asymptomatic bacteriuria. This article reviews diagnostic stewardship methods and closes with a case study illustrating these principles in practice.
尿路感染是医疗保健中最常见的感染性诊断之一，但大多数尿路感染在没有感染迹象或症状的患者中被不恰当地诊断。无症状菌尿导致不适当的抗生素处方和负面的下游影响，包括抗菌药物耐药性、与医疗保健相关的感染和药物不良事件。诊断管理是指修改测试结果的订购、执行或报告以改善临床护理的过程。诊断管理会影响诊断途径，以减少无症状菌尿的不当检测和治疗。本文回顾了诊断管理方法，并以一个案例研究说明了这些原则在实践中的应用。
