%0 Journal Article
%T Impact of selective reporting of antibiotic susceptibility testing results for urinary tract infections in the outpatient setting: a prospective controlled before-after intervention study.
%A Simon M
%A Fougnot S
%A De Monchy P
%A Duda A
%A Thilly N
%A Pulcini C
%A  
%J Clin Microbiol Infect
%V 29
%N 7
%D Jul 2023 13
%M 36921718
%F 13.31
%R 10.1016/j.cmi.2023.03.012
%X <B>OBJECTIVE: </B>The use of selective reporting of antibiotic susceptibility testing (AST) results is a recommended antimicrobial stewardship strategy to improve the appropriateness of antibiotic prescriptions. We conducted a large, pragmatic, prospective, multicentre, controlled (selective reporting versus complete reporting) before-after intervention study to assess the impact of selective reporting of AST results for Escherichia coli-positive urine cultures on the prescription of broad-spectrum antibiotics carrying a higher risk of selection of resistance (i.e. amoxicillin-clavulanate, third-generation cephalosporins, and quinolones) in the outpatient setting. We also looked for possible unintended clinical consequences of the intervention leading to consultations and/or hospitalizations.<BR><B>METHODS: </B>We compared two groups of laboratories located in a French region. We collected data from the health insurance databases before (2017) and after the implementation of the intervention (2019). The primary outcome was the prescription proportion of broad-spectrum antibiotics.<BR><B>RESULTS: </B>We included 42,956 Escherichia coli-positive urine cultures with AST. The decrease in the proportion of broad-spectrum antibiotic prescriptions between 2017 and 2019 was significantly higher for selective reporting of AST, attributable to a decrease in the prescription proportion of third-generation cephalosporins (-8.5% for selective reporting versus -0.1% for complete reporting, p < 0.001). This impact was more marked for targeted therapy and female patients. Requests from clinicians for the complete reporting of AST results were infrequent (1.2% of all the selective AST results reported in 2019). No unintended consequences were observed.<BR><B>CONCLUSIONS: </B>The results showed a positive impact of the selective reporting of AST results, but room for improvement is still important.