Failure to Ensure Appropriate Antibiotic Use for UTI
Penalty
Summary
The facility failed to ensure appropriate antibiotic use for a resident with a urinary tract infection (UTI). Medical record review showed that the resident, who had multiple complex diagnoses including chronic obstructive pulmonary disease, respiratory failure, Parkinson's disease, and an indwelling urinary catheter, was prescribed Bactrim DS for a UTI. The resident's care plan included regular catheter care and interventions to prevent infection. However, the hospital record indicated that the initial urine culture showed mixed microbial growth with suspected contamination and recommended recollection and further work up. No sensitivity testing was performed, and no follow-up urine culture was completed to confirm the appropriateness of the prescribed antibiotic. Further review of the resident's medical record confirmed that no additional urine cultures or sensitivity testing were conducted to determine if Bactrim was an appropriate treatment. Staff interview with an LPN verified that no culture and sensitivity testing was performed. The facility's antimicrobial stewardship policy required the use of revised McGeer's Criteria and appropriate diagnostic testing to ensure antibiotics were prescribed only when necessary and appropriate, but these steps were not followed in this case.