For Some Long Term Care Physicians, Urinalysis Results Trump Other Prescribing Guidelines

Some physicians who treat nursing home residents are basing their decisions to prescribe antibiotics for suspected urinary tract infections (UTIs) primarily on urinalysis results, which are an unreliable indicator, according to an Agency for Healthcare Research and Quality (AHRQ)-funded study published in the Journal of the American Medical Directors’ Association. In surveys administered to 876 primary care physicians and advanced practice providers, researchers asked which patient characteristics are most important when deciding whether to prescribe antibiotics to nursing home residents. On average, they found that urinalysis results led to 32 percent of final prescribing decisions. This was a greater proportion compared with lower urinary tract symptoms (17 percent), body temperature (17 percent) and physical examinations (15 percent), each of which is recommended in the guidelines for diagnosis.

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