Stool cultures and antimicrobial prescriptions related to infectious diarrhea.

Stool cultures can be important in guiding antimicrobial therapy for diarrhea. From among 11.64 million person-years of Tennessee Medicaid enrollment data collected from 1995 through 2004, 315,828 diarrheal episodes were identified. Stool cultures were performed for only 15,820 episodes (5.0%). Antimicrobials were prescribed for 32,949 episodes (10.4%), 89.4% of which were not accompanied by a stool culture. White race and urban residence were associated with higher rates of stool culture. Frequent use of antimicrobials for diarrhea without stool culture may indicate inappropriate antimicrobial use and has critical implications for public health.

[1]  L. Wolf,et al.  Practices around acute diarrheal illness diagnosis, counseling, and reporting: laboratory and health-care practitioners in North Carolina, 2004. , 2007, Foodborne pathogens and disease.

[2]  A. Cronquist,et al.  A population-based estimate of the substantial burden of diarrhoeal disease in the United States; FoodNet, 1996–2003 , 2006, Epidemiology and Infection.

[3]  M. Beach,et al.  The rate of acute gastrointestinal illness in developed countries. , 2006, Journal of water and health.

[4]  A. Cronquist,et al.  Antimicrobial use and outcomes in patients with multidrug-resistant and pansusceptible Salmonella Newport infections, 2002-2003. , 2005, Microbial drug resistance.

[5]  D. Musher,et al.  Contagious acute gastrointestinal infections. , 2004, The New England journal of medicine.

[6]  T. Jones,et al.  Limitations to successful investigation and reporting of foodborne outbreaks: an analysis of foodborne disease outbreaks in FoodNet catchment areas, 1998-1999. , 2004, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[7]  G. Zou,et al.  A modified poisson regression approach to prospective studies with binary data. , 2004, American journal of epidemiology.

[8]  P. Griffin,et al.  Culturing practices and antibiotic use in children with diarrhea. , 2004, Pediatrics.

[9]  W. Schaffner,et al.  Changes in antibiotic prescribing for children after a community-wide campaign. , 2002, JAMA.

[10]  L B Reller,et al.  Practice guidelines for the management of infectious diarrhea. , 2001, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[11]  I. Nachamkin,et al.  Inappropriate testing for diarrheal diseases in the hospital. , 1990, JAMA.

[12]  P. Albert,et al.  Models for longitudinal data: a generalized estimating equation approach. , 1988, Biometrics.

[13]  T. Dewitt,et al.  Clinical predictors of acute bacterial diarrhea in young children. , 1985, Pediatrics.

[14]  H. Fineberg,et al.  VALUE OF STOOL CULTURES , 1980, The Lancet.