200. Pharmacist Prescribing and Care for Patients with Uncomplicated Urinary Tract Infections in the Community: Antimicrobial Utilization and Stewardship Results of the RxOUTMAP Study
Notice bibliographique
Résumé
Urinary tract infections (UTI) are common infections that often result in antibacterial use that is suboptimal. There are some Canadian provinces where pharmacists have the authorization to prescribe medications for the treatment of uncomplicated UTI. Pharmacists are accessible primary care professionals who have an important role to play in antimicrobial stewardship. Our objective was to evaluate the appropriateness of antibacterial prescribing by pharmacists for patients with uncomplicated UTI. We conducted a prospective registry trial in 39 community pharmacies in the Canadian province of New Brunswick. Adult patients were enrolled if they presented to the pharmacy with either symptoms of UTI with no current antibacterial treatment (Pharmacist-Initial Arm) or if they presented with a prescription for an antibacterial to treat UTI from a physician (Physician-Initial Arm). Pharmacists assessed patients and if they had complicating factors or red flags for systemic illness of pyelonephritis, they were excluded from the study. Pharmacists either prescribed antibacterial therapy, modified antibacterial therapy, provided education only, or referred to a physician, as appropriate. Antibacterial therapy prescribed was compared between the study arms. A total of 748 patients were enrolled (87% in the Pharmacist-Initial Arm). The most commonly prescribed agents in the Pharmacist-Initial Arm were nitrofurantoin (88%), sulfamethoxazole–trimethoprim (TMP-SMX) (8%), and fosfomycin (2%) vs. nitrofurantoin (54%), TMP-SMX (26%), and fluoroquinolones (11%) in the Physician-Initial Arm. Nitrofurantoin was prescribed for 5 days in 97% of Pharmacist-Initial orders when compared with Physician-Initial orders where 65% were for greater than 5 days. TMP-SMX was prescribed for 3 days in 88% of Pharmacist-Initial compared with Physician-Initial where 63% were for greater than 3 days. Therapy was guideline concordant in 95% of Pharmacist-Initial compared with 35% of Physician-Initial (P < 0.001). For guideline-discordant therapy from physicians, pharmacists prescribed to optimize therapy for 46% of patients. Treatment was more guideline concordant when initiated by pharmacists, with longer treatment durations and more fluoroquinolones prescribed by physicians. All authors: No reported disclosures.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».