Routine Urine Testing at the Spinal Cord Injury Annual Evaluation Leads to Unnecessary Antibiotic Use: A Pilot Study and Future Directions

The study found that routine urine tests during annual checkups for veterans with spinal cord injuries often showed bacteria, but most were asymptomatic. Despite this, many veterans were given antibiotics unnecessarily. This practice goes against medical guidelines that advise against treating asymptomatic bacteriuria (ASB) to avoid antibiotic overuse and resistance. The researchers suggest that a better understanding is needed regarding why urine testing is mandated during these annual exams, and to develop better strategies to reduce unnecessary antibiotic use in this population.

• 1
  Most positive urine cultures from SCI annual evaluations represented ASB cases.
• 2
  More than a third of ASB cases were treated with antibiotics, against IDSA guidelines.
• 3
  Factors predicting antibiotic use were higher age, nitrite presence on urinalysis, and urease-producing organism on culture.