The usefulness of previous urine culture and antibiogram results in guiding empiric antibiotic selection in the emergency department


Ozay Y., Sever M., Yesilaras M., Unal A., Gursoy O.

Irish Journal of Medical Science, 2025 (SCI-Expanded, Scopus) identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2025
  • Doi Number: 10.1007/s11845-025-04124-x
  • Journal Name: Irish Journal of Medical Science
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Biotechnology Research Abstracts, CAB Abstracts
  • Keywords: Antibiogram, Antibiotic sensitivity, Emergency department, Urinary tract infection, Urine culture
  • Uşak University Affiliated: No

Abstract

Background: Urinary tract infection (UTI) symptoms are common reasons for emergency department (ED) admissions. Selecting appropriate antibiotics is crucial in terms of both resistance prevention and clinical recovery. Aims: We aimed to evaluate the usefulness of urine culture (UC) and antibiogram results in guiding empiric antibiotic selection and the compatibility of prescribed antibiotics at discharge with the ED UC and antibiogram results. Methods: Patients who presented to the ED over 1-year period and had prior UC results were enrolled in study retrospectively. Patients were excluded if their ED UCs were revealed as contaminated and showed no growth, or if their previous UCs had no growth despite positive ED UC results. Patients without an antibiogram in previous positive UCs were also excluded. Antibiotics prescribed at discharge were compared with the ED and previous culture/antibiogram findings to assess for appropriateness. Results: Eight thousand six hundred ninety-nine patients’ charts were reviewed. Of the UCs, 36.2% were revealed as growth. When contamination results were excluded, growth ratio was decreased to 25.1%. The average age was 57 years. E. coli (51.3%) was the most frequently isolated pathogen. The most frequently prescribed antibiotic was cefixime. Empirically prescribed antibiotics consistency with the ED culture/antibiogram was 38%. If it had been written according to the previous culture/antibiogram result, it could have increased the consistency up to 64.8%. Conclusion: Using previous UC/antibiogram results to choose appropriate empiric antibiotics for UTIs may provide increased accuracy in selecting the appropriate empirical antibiotic for one in every four patients without new UC/antibiogram results.