THE OVERUSE OF EMPIRIC ANTIBIOTIC TREATMENT FOR ENTEROCOLITIS DIAGNOSED BY ABDOMINAL CT (OVERACCT)
AUTHORS : Saliaj, Merjona, Aloysius, Mark M, Khan, Muneer, Singh, Julie, Acharya, Luna, Burger, Susanne
INSTITUTIONS : 1. Internal Medicine, Icahn School of Medicine at Mount Sinai, Bronx, VA, Bronx, NY; 2. Internal Medicine, North Central Bronx hospital, Bronx, NY, United States.
BACKGROUND
Computed tomography (CT) is widely used imaging tool in the assessment of abdominal symptoms. Consequently, radiological diagnosis of enterocolitis is commonly reported in the context of incidental non-specific bowel wall thickening despite its poor specificity in identifying true enterocolitis. The gold standard diagnosis of enterocolitis is intestinal biopsy, however is invasive and not always feasible. Such labelling leads to reflex and inappropriate use of antibiotic therapy until the diagnosis is disproved, even when the lack of diarrhea, a pathognomonic sign of enterocolitis. This study evaluated the inappropriate use of antibiotics for CT diagnosed enterocolitis in the absence of sufficient clinical symptoms.
METHODS …show more content…
Inclusion criteria were met by a total of 86 subjects identified by diagnosis code of enterocolitis. with gastrointestinal symptoms including abdominal pain, nausea, vomiting, or diarrhea. 59 of these patients had further investigation with abdominal CT to rule out acute abdominal conditions based on their clinical presentation, ultrasound, or x-rays. Radiologically visualized bowel thickening was diagnosed as enterocolitis. Chart review included relevant history, antibiotic use and its appropriateness, laboratory data for inflammatory markers (CRP, ESR), stool studies. EGD or colonoscopy data with histopathology results were compared with the radiological diagnosis of enterocolitis for
AUTHORS : Saliaj, Merjona, Aloysius, Mark M, Khan, Muneer, Singh, Julie, Acharya, Luna, Burger, Susanne
INSTITUTIONS : 1. Internal Medicine, Icahn School of Medicine at Mount Sinai, Bronx, VA, Bronx, NY; 2. Internal Medicine, North Central Bronx hospital, Bronx, NY, United States.
BACKGROUND
Computed tomography (CT) is widely used imaging tool in the assessment of abdominal symptoms. Consequently, radiological diagnosis of enterocolitis is commonly reported in the context of incidental non-specific bowel wall thickening despite its poor specificity in identifying true enterocolitis. The gold standard diagnosis of enterocolitis is intestinal biopsy, however is invasive and not always feasible. Such labelling leads to reflex and inappropriate use of antibiotic therapy until the diagnosis is disproved, even when the lack of diarrhea, a pathognomonic sign of enterocolitis. This study evaluated the inappropriate use of antibiotics for CT diagnosed enterocolitis in the absence of sufficient clinical symptoms.
METHODS …show more content…
Inclusion criteria were met by a total of 86 subjects identified by diagnosis code of enterocolitis. with gastrointestinal symptoms including abdominal pain, nausea, vomiting, or diarrhea. 59 of these patients had further investigation with abdominal CT to rule out acute abdominal conditions based on their clinical presentation, ultrasound, or x-rays. Radiologically visualized bowel thickening was diagnosed as enterocolitis. Chart review included relevant history, antibiotic use and its appropriateness, laboratory data for inflammatory markers (CRP, ESR), stool studies. EGD or colonoscopy data with histopathology results were compared with the radiological diagnosis of enterocolitis for