Short summary

Inappropriate antibiotic treatment is an important modifiable driver of antimicrobial resistance and urinary tract infections (UTI) are among the most frequent indications for treatment. Still, diagnosis and treatment of UTIs in elderly patients remains challenging.

The aim of this study is to examine the frequency of use, indication, interpretation, and clinical consequences of urinary dipsticks at hospitals.

The study population include all adults examined with urinary dip sticks at Emergency Department (ED) in Odense. The results will be compared to results from The Region of Northern Denmark.

Rationale

The diagnosis of UTI in elderly patients at hospital is often based on non-specific symptoms e.g. confusion or behavioral changes, combined with results of urinary dipsticks, and followed by empiric antibiotics. Use of dipsticks in this setting is controversial since urine sampling might not always be performed the most optimal way (i.e. clean, mid-stream sample). Detection of leukocytes and nitrite analysis of urinary dipsticks have a low positive predictive value and a high negative predictive value in elderly patients suspected for UTI.

Description of the cohort

The study is a Descriptive registry-based analyses with evaluation of the use of dipsticks of all acute medical hospitalized, adult patients through the emergency department. The results will both serve as a comparable study population to the one in Aalborg and furthermore improve understanding of use, indication, and clinical consequences og urinary dip stick.

Data and biological material

Key data source in Odense is medical records of all acute medical hospitalised patients through the Emergency Department at Odense University Hospital in November 2019. Data on urinary dipsticks, comorbidities, final diagnosis of the index admission, blood tests, microbiological analyses, antibiotic treatment, intensive care unit admission (ICU) etc. will be obtained.

Collaborating researchers and departments

Department of Infectious Medicine, Aalborg University Hospital

• Jacob Bodilsen, Chief Physician, PhD

Department of Clinical Pharmacology and Pharmacy, University of Southern Denmark

• Anton Pottegård, Clinical Pharmacist