Impact of Diagnostic Stewardship on Urine Culture Ordering in Saudi Arabia: Prospective Pre- and Postintervention Study

Abstract BackgroundInappropriate testing of urine cultures can lead to overuse of antibiotics, antimicrobial resistance, Clostridioides difficile ObjectiveWe assessed the implementation of a clinical decision support (CDS) tool in diagnostic stewardship, focusing o...

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Main Authors: Ahlam Alghamdi, Afrah Alkazemi, Alnada Ibrahim, Mohammed Alraey, Mohammed Alaboud, Isra Farooqi, Mohammad Aatif Khan, Asem Allam, Mohammed Alwadai, Renad Alyahya, Ohoud Alzahrani, Hajar Y AlQahtani, Amir Mohareb, Muneerah Aleissa
Format: Article
Language:English
Published: JMIR Publications 2025-07-01
Series:JMIR Medical Informatics
Online Access:https://medinform.jmir.org/2025/1/e68044
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Summary:Abstract BackgroundInappropriate testing of urine cultures can lead to overuse of antibiotics, antimicrobial resistance, Clostridioides difficile ObjectiveWe assessed the implementation of a clinical decision support (CDS) tool in diagnostic stewardship, focusing on the appropriateness of urine culture orders and antibiotic use. MethodsWe examined differences in urine culture testing and antibiotic use before and after implementation of a CDS tool in a 400-bed hospital in Riyadh, Saudi Arabia, from August 2021 to July 2022. We included adult patients with urine culture orders. Our outcomes were the percentage of urine cultures ordered that were inappropriate and antibiotic use after the implementation of the CDS intervention. We used a multivariable logistic regression model to determine factors associated with inappropriate urine culture testing and antibiotic use. ResultsThe percentage of inappropriate urine culture orders were significantly lower in the postintervention period compared to the preintervention period (821/2254, 36.4% vs 754/1814, 41.6%; PPPP ConclusionsA CDS initiative can reduce unnecessary urine culture testing and antibiotic overuse.
ISSN:2291-9694