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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author 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
author_facet 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
author_sort Ahlam Alghamdi
collection DOAJ
description 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.
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institution Kabale University
issn 2291-9694
language English
publishDate 2025-07-01
publisher JMIR Publications
record_format Article
series JMIR Medical Informatics
spelling doaj-art-fa884ca798f84393923bfb02839ae9ac2025-08-20T03:34:36ZengJMIR PublicationsJMIR Medical Informatics2291-96942025-07-0113e68044e6804410.2196/68044Impact of Diagnostic Stewardship on Urine Culture Ordering in Saudi Arabia: Prospective Pre- and Postintervention StudyAhlam Alghamdihttp://orcid.org/0000-0002-7664-8044Afrah Alkazemihttp://orcid.org/0000-0003-2456-8736Alnada Ibrahimhttp://orcid.org/0000-0002-4604-4653Mohammed Alraeyhttp://orcid.org/0009-0005-3918-9415Mohammed Alaboudhttp://orcid.org/0009-0007-8392-9120Isra Farooqihttp://orcid.org/0009-0001-0740-0125Mohammad Aatif Khanhttp://orcid.org/0009-0009-1269-8681Asem Allamhttp://orcid.org/0000-0002-4308-6583Mohammed Alwadaihttp://orcid.org/0009-0009-0673-3938Renad Alyahyahttp://orcid.org/0009-0001-4756-4976Ohoud Alzahranihttp://orcid.org/0009-0004-9043-0721Hajar Y AlQahtanihttp://orcid.org/0000-0002-7719-8209Amir Moharebhttp://orcid.org/0000-0002-3761-6154Muneerah Aleissahttp://orcid.org/0000-0003-2167-5122 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.https://medinform.jmir.org/2025/1/e68044
spellingShingle 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
Impact of Diagnostic Stewardship on Urine Culture Ordering in Saudi Arabia: Prospective Pre- and Postintervention Study
JMIR Medical Informatics
title Impact of Diagnostic Stewardship on Urine Culture Ordering in Saudi Arabia: Prospective Pre- and Postintervention Study
title_full Impact of Diagnostic Stewardship on Urine Culture Ordering in Saudi Arabia: Prospective Pre- and Postintervention Study
title_fullStr Impact of Diagnostic Stewardship on Urine Culture Ordering in Saudi Arabia: Prospective Pre- and Postintervention Study
title_full_unstemmed Impact of Diagnostic Stewardship on Urine Culture Ordering in Saudi Arabia: Prospective Pre- and Postintervention Study
title_short Impact of Diagnostic Stewardship on Urine Culture Ordering in Saudi Arabia: Prospective Pre- and Postintervention Study
title_sort impact of diagnostic stewardship on urine culture ordering in saudi arabia prospective pre and postintervention study
url https://medinform.jmir.org/2025/1/e68044
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