Antibiotics Often Used Inappropriately for Catheter-Associated Bacteriuria

NEW YORK (Reuters Health) - Clinicians often don't know how to manage catheter-associated asymptomatic bacteriuria, so they overtreat it with antibiotics, a new survey suggests.

"We found that health care providers' cognitive biases, or mental shortcuts, are set incorrectly," said principal investigator Dr. Barbara W. Trautner of the Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine in Houston, Texas.

"Certain cues ingrained during medical training, such as elevated white blood cells in the urine being diagnostic of urinary tract infection (UTI) in young women, are being applied incorrectly to patients with urinary catheters. These incorrect mental shortcuts lead to over-diagnosis of UTI in hospitalized patients with urinary catheters," she told Reuters Health by email.

>LEARN MORE about education and better methods to avoid overtreatment from medscape.com 

Old Antibiotic for Uncomplicated Urinary Tract Infection

CAPE TOWN, South Africa — In hospitalized patients with uncomplicated urinary tract infections (UTIs), cure rates with oral fosfomycin, an old antibiotic, are excellent, even in those colonized with resistant organisms, a new study shows.

"Results from this project showed an 83% cure rate. Even in patients who did not achieve a clinical cure, only about 3% overtly failed therapy," said investigator Shauna Jacobson, PharmD, from the Orlando Regional Medical Center in Florida.

"We recently restricted fluoroquinolones at our hospital, and then we went on to restrict meropenem," she told Medscape Medical News. Although "fosfomycin has been studied pretty well in community patients, especially in patients with uncomplicated cystitis, it hasn't been well studied in hospitalized patients," she said. "We wanted to see how our patients did on it."

The study results were presented here at the 16th International Congress on Infectious Diseases.

READ FULL ARTICLE for use in low risk patients from medcape.com

Popular Antibiotics May Carry Serious Side Effects - NYTimes.com

Antibiotics are important drugs, often restoring health and even saving lives. But like all drugs, they can have unwanted and serious side effects, some of which may not become apparent until many thousands of patients have been treated.

Such is the case with an important class of antibiotics known as fluoroquinolones. The best known are Cipro (ciprofloxacin), Levaquin (levofloxacin) and Avelox (moxifloxacin). In 2010, Levaquin was the best-selling antibiotic in the United States.

But by last year it was also the subject of more than 2,000 lawsuits from patients who had suffered severe reactions after taking it.

Part of the problem is that fluoroquinolones are often inappropriately prescribed. Instead of being reserved for use against serious, perhaps life-threatening bacterial infections like hospital-acquired pneumonia, these antibiotics are frequently prescribed for sinusitis, bronchitis, earaches and other ailments that may resolve on their own or can be treated with less potent drugs or nondrug remedies — or are caused by viruses, which are not susceptible to antibiotics.

via Popular Antibiotics May Carry Serious Side Effects - NYTimes.com.