Background, Rationale and Suggested Implementation Strategies
- Develop institutional guidelines, locally adapted from national and HMS guidelines, for treatment of community-acquired pneumonia (CAP) and urinary tract infection (UTI)/asymptomatic bacteriuria (ASB). If institution specific guidelines already exist, they should comply with the following:
CAP
Institutional guidelines should:
- Recommend 5-day antibiotic treatment duration for uncomplicated CAP
- Reflect the IDSA/ATS CAP guidelines, taking into account pneumonia severity and risk factors for MRSA and antibiotic-resistant Gram-negative pathogens, which may warrant broader empiric antibiotic therapy
- Provide recommendations for transition to oral therapy
- De-emphasize fluoroquinolones
UTI/ASB
Institutional guidelines should:
- Recommend against sending urine cultures in the absence of urinary symptoms
- Recommend against treating a positive urine culture in the absence of urinary symptoms
- De-emphasize fluoroquinolones
- Provide recommendations for transition to oral therapy
- Share the CAP and UTI/ASB guidelines with members of the work group and front-line providers to get feedback and to ensure buy-in.
- Publish guidelines in multiple formats, including booklets, hospital intranet, or an application for smartphones.
- Share HMS data and local opportunities for improvement institution-wide.
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