Why clinicians should stop ordering so many urine tests

Many physicians order urine tests out of habit, not necessity, which can contribute to antibiotic overuse, according to The New York Times.

Urine cultures often test positive for bacteria even though patients aren't experiencing symptoms of infection, which is referred to as asymptomatic bacteriuria. This trend is especially common in older patients.

Many physicians automatically write patients an antibiotic prescription for a positive urine culture, even if it isn't always needed, according to NYT.

"Once a clinician sees bacteria in the urine, the reflex is, you can't ignore it. You want to treat it," Christine Soong, MD, head of hospital medicine at Sinai Health System in Toronto, told the publication.

Public health experts and researchers have tried to address this propensity for overtreatment with limited success. Now, they're taking a new approach: trying to prevent clinicians from ordering unnecessary urine tests.

Health systems are getting on board with this effort by adding pop-up alerts when physicians attempt to order a urine culture in the EHR, among other initiatives. Dr. Soong said her hospital is withholding test results unless physicians request them from lab services. This strategy led to a 36 percent drop in antibiotic prescriptions written for asymptomatic bacteriuria, according to NYT.

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