ArticleJMIR medical informatics2025
Impact of Diagnostic Stewardship on Urine Culture Ordering in Saudi Arabia: Prospective Pre- and Postintervention Study.
Article in JMIR medical informatics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- A stepwise antimicrobial and diagnostic stewardship intervention for ordering urine cultures in Saudi Arabia: a quasi-experimental study.Frontiers in cellular and infection microbiology · 2026Article
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Inappropriate testing of urine cultures can lead to overuse of antibiotics, antimicrobial resistance, Clostridioides difficile infections, and increased cost. In Saudi Arabia, antimicrobial stewardship programs have improved antibiotic use but lack focus on asymptomatic bacteriuria. Targeted interventions are needed to address this gap. Objective: We assessed the implementation of a clinical decision support (CDS) tool in diagnostic stewardship, focusing on the appropriateness of urine culture orders and antibiotic use. Methods: We examined differences in urine culture testing and antibiotic use before and after implementation of a CDS tool in a 400-bed hospital in Riyadh, Saudi Arabia, from August 2021 to July 2022. We included adult patients with urine culture orders. Our outcomes were the percentage of urine cultures ordered that were inappropriate and antibiotic use after the implementation of the CDS intervention. We used a multivariable logistic regression model to determine factors associated with inappropriate urine culture testing and antibiotic use. Results: The percentage of inappropriate urine culture orders were significantly lower in the postintervention period compared to the preintervention period (821/2254, 36.4% vs 754/1814, 41.6%; P=.001). The CDS intervention was associated with 16.7% lower odds of inappropriate urine culture ordering (adjusted odds ratio [aOR] 0.83, 95% CI 0.73-0.95; P=.008). Unnecessary antibiotics were significantly lower in the postintervention period (310/2254, 72.9% vs 288/1814, 85.7%; P<.001). The CDS intervention was associated with a 52% reduction in unnecessary antibiotic use (aOR 0.487, 95% CL 0.332-0.713; P<.001). Conclusions: A CDS initiative can reduce unnecessary urine culture testing and antibiotic overuse.
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