Routine admission urinalysis has low clinical utility in psychiatric hospitalizations

TL;DR

Routine urinalysis during psychiatric hospitalizations rarely detects urinary tract infections and often leads to unnecessary antibiotic use.

Contribution

This study quantifies the low clinical value and high rate of inappropriate antibiotic prescriptions from routine admission urinalysis in psychiatric settings.

Findings

Admission urinalyses identified urinary tract infections in only 1.7% of psychiatric patients.

71.3% of antibiotic prescriptions based on urinalysis results were inappropriate.

Inappropriate prescriptions were more common in older patients, females, those with positive cultures, and specific psychiatric diagnoses.

Abstract

We examined the diagnostic utility of urinalyses (UAs) in psychiatric admissions. Admission UAs led to diagnosis of clinical urinary tract infections in 1.7% of cases. Among those treated with antibiotics, inappropriate prescriptions occurred in 71.3% of cases, with increased odds in older age, female sex, positive cultures, and certain psychiatric diagnoses.

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