Discussion
UTIs, UTI, cystitis, nonsyndromic
ADVERSE EFFECTS, CYSTITIS, ASYMPTOMATIC BACTERIURIA, UTI
The current study shows that, on average, providing NH clinicians with a urine-specific antibiogram, regardless of format, at the time of antibiotic prescribing is associated with an increased likelihood of selecting an antibiotic that is active against pathogens previously recovered in an NH. Use of either antibiogram tool was also associated with increased likelihood of choosing optimal therapy, suggesting these tools not only enhance the likelihood of prescribing an active antibiotic but also minimize the use of broad-spectrum agents which may further reduce adverse effects of antibiotic therapy.Although the tools did not perform differently from each other overall, the tools performed differently in different clinical scenarios. The most notable example is use of the traditional antibiogram in case 4, which depicts an NH resident with recent prior cystitis from an extended-spectrum β-lactamase–producing Very little is known about the outcomes of antibiogram use in NHs. As inappropriate prescribing for asymptomatic bacteriuria is a major concern in NHs, interventions to improve antibiotic decision-making have primarily focused on the decision to initiate antibiotics.We chose to test 2 syndromic antibiogram formats in this study, focusing on empirical prescribing for UTIs instead of traditional, nonsyndromic cumulative susceptibility reports. Urine is the most common source for microbiology cultures and UTI is the leading indication for NH-initiated antibiotics.