How Best to Dissuade Clinicians from Treating Patients with Asymptomatic Bacteriuria?

Evidence clearly shows that antibiotics are unnecessary for most patients with asymptomatic bacteriuria (ASB) — but many patients get treated anyway, particularly if they are older or have indwelling catheters. Can this practice be stopped by dissuading clinicians from treating these patients? Or is it more effective just to deter clinicians from ordering cultures in the first place?

Three years into a Michigan statewide quality-improvement project that started in 2017 (in which both approaches were employed), investigators evaluated data on about 15,000 nonpregnant patients with positive urine cultures from 46 hospitals. Included patients were not immunocompromised and didn't have anatomic anomalies that might justify treatment in the absen…