Improving rational prescribing for UTI in frail elderly
Frail elderly are frequently diagnosed with urinary tract infection (UTI) and half of the antibiotics (AB) used in this population are for UTI. However, a substantial part of these AB might not be necessary, because presenting signs and symptoms are erroneously ascribed to a UTI. Antibiotic stewardship interventions are much needed and the proposed project aim to reduce AB overuse for UTI in frail elderly.
Project supported by VR (3,048 MSEK) for the period 2018-2020.
Main PI is Pär-Daniel Sundvall from Department of Public Health and Community Medicine at UGOT.
Frail elderly are frequently diagnosed with urinary tract infection (UTI) and half of the antibiotics (AB) used in this population are for UTI. However, a substantial part of these AB might not be necessary, because presenting signs and symptoms are erroneously ascribed to a UTI. Antibiotic stewardship interventions are much needed and the proposed project aim to reduce AB overuse for UTI in frail elderly.The project consists of three work packages (WP) to be conducted in the Netherlands, Sweden, Norway and Poland during a three year period planned to start in January 2018:WP1: To develop a conceptual model of factors influencing AB prescribing with a focus on (alleged) UTI, using semi structured interviews. To compose a toolbox of interventions to support rational and restrictive prescribing of AB in UTI.WP2: To design a tailored intervention to reduce inappropriate AB prescribing and usage of AB for UTI by implementing an algorithm that encourages ‘watchful waiting’ in case of non-specific signs and symptoms, combined with a bundle of actions selected on the basis of the above mentioned conceptual model and with use of the toolbox. Furthermore, to conduct a RCT evaluating this multifaceted intervention in frail elderly in institutional and community care settings.WP3: To conduct and evaluate a double blinded RCT on the safety and effectivity of preventive use of methenamine hippurate in community dwelling and institutionalized women aged > 70 with recurrent UTI.