Impact of an ASP intervention on the request for post-treatment control urine cultures in primary care.

Abstract

Introduction: With the aim of reducing the number of Post-Treatment Control Urine Cultures (UC) from Health Centers in our healthcare area, we conducted an Antimicrobial Stewardship Program (ASP) intervention throughout 2022. To do this, we set out to introduce effective methods to quantify, analyze, and subsequently try to reduce the number of inappropiate UC.

Methods: We conducted a prospective and non-restrictive quasi-experimental intervention study with historical and parallel control group to evaluate the impact of the intervention. The UC evaluation was performed by analyzing all the medical records of repeated UC in a period of less than 31 days. UC were classified as: appropriate, inappropriate and doubtful. The study was conducted in 3 phases: phase 1) measurement of the baseline situation; phase 2) intervention in intervention group: simple educational presentations and implementation of a non-restrictive computerized rule, and phase 3) analysis of results in both groups and periods.

Results: Looking at the %AUC, we observed that in the control group there was hardly any variation while in the intervention group (IG) these increased by 152.4 (p < 0.001). In addition, in the IG there was a decrease in total UCs of 55.4% (n = 418), representing an estimated savings of €7524. The acceptance of the CR in the IG was 9.6%.

Conclusions: This ASP intervention is useful in decreasing the number of IUCs, especially the educational presentations. Achieving this can reduce direct and indirect patient harm and healthcare overload, in addition to improving the management of healthcare resources.