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This is a multicenter, observational comparative cohort, study to evaluate the UTI related adverse event rates between Guidance® UTI clinical pathway versus the current traditional clinical pathways for urine testing.
Clinical sites will be identified by an internal database, prepared by the sponsor, based on previous experience with the sites. Study allocation will based on their current usage of Guidance® UTI and the reporting pathway (described above) will be implemented. Those who currently routinely use Guidance® UTI testing procedures will be over sampled 2:1 over those who do not routinely use Guidance® UTI. Larger clinical care systems with multiple care sites may have locations allocated to different cohort. The basis for cohort allocation will be based on the availability and willingness of providers in these markets to implement infrastructure for collecting and reporting of Guidance® UTI clinical pathway. The comparative cluster cohort will be selected from select geographies within the U.S. based on size of general population served matching to those enrolled in the Guidance® UTI clinical pathway.
The method of patient care and management (e.g., test ordering and antimicrobial initiation) is at the discretion of the treating physicians. Specimens collected for suspected UTI may be sent to Pathnostics for standard bacterial identification and sensitivities. Guidance® UTI can only be performed at Pathnostics, whereas urine cultures may be performed at any lab. Trained and experienced clinical lab scientists at Pathnostics are always available to assist the ordering provider with results interpretation or any other questions on the report they may have.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Guidance clinical pathway | Sites will be provided a standardized infrastructure and process for collecting and reporting of urine test results including unique lab requisitions that contain the option to order Guidance® UTI, Standard Urine Culture (SUC), and Urine Analysis (UA) along with a protocol for results notification. | ||
| Traditional clinical pathway | Sites will employ their current standard clinical care practices for suspected UTI, including Standard Urine Culture (SUC), Urine Analysis (UA), and Guidance® UTI testing as per current reporting practices. Providers at these facilities will have the option to order any diagnostic test they deem appropriate. |
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| Measure | Description | Time Frame |
|---|---|---|
| UTI-related ED visit and/or hospitalization within 30 days of index visit | UTI-related ED visit and/or hospitalization within 30 days of index visit | within 30 days of index visit |
| Composite of adverse events associated with index UTI event | Composite of adverse events associated with index UTI event Allergic reactions to antibiotic therapy Progression to pyelonephritis Nausea/vomiting, headache, skin rash, anaphylaxis/hypersensitivity reaction yeast infection (Vaginitis/vulvovaginal candidiasis) Progression to acute renal failure Tendinopathy (including tendon rupture) C. difficile infection Sepsis | within 30 days of index visit |
| Recurrent UTI (rUTI) - The proportion of subjects reporting recurrence of symptomatic UTI and receive antimicrobial treatment (re-prescription) within 30 days. | Recurrent UTI (rUTI) - The proportion of subjects reporting recurrence of symptomatic UTI and receive antimicrobial treatment (re-prescription) within 30 days. | within 30 days of index visit |
| Measure | Description | Time Frame |
|---|---|---|
| Rate of empirical antibiotic starts for UTI indication | Rate of empirical antibiotic starts for UTI indication | within 1 year of index visit |
| Rate of antimicrobial changes for UTI indication | Rate of antimicrobial changes for UTI indication |
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Inclusion
Exclusion
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Patients ≥ 65 years of age seen by healthcare professional for UTI
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Dispatch Health | Denver | Colorado | 80205 | United States |
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| ID | Term |
|---|---|
| D014552 | Urinary Tract Infections |
| ID | Term |
|---|---|
| D007239 | Infections |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
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| within 1 year of index visit |
| Recurrent UTI within 1 year of index visit suspected UTI as measured by total antibiotics prescribed. | Recurrent UTI within 1 year of index visit suspected UTI as measured by total antibiotics prescribed. | within 1 year of index visit |
| UTI-related ED visit and/or hospitalization within 1 year of index visit | UTI-related ED visit and/or hospitalization within 1 year of index visit | within 1 year of index visit |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |