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{"sheet":"Data Input","index":0,"n_rows":19,"n_cols":12,"rows_kept":19,"cut":false,"hidden":false,"merged":[[0,0,0,7],[0,8,0,10],[18,0,24,0],[25,0,25,7],[3,0,5,0],[6,0,14,0],[15,0,17,0],[18,2,18,6],[19,2,24,5]]}
["Audit Tool for UTI Prophylaxis Patients"]
[]
[null,{"$f":"TODAY()","v":"2021-06-22"},"Patient 1","Patient 2","Patient 3","Patient 4","Patient 5","Patient 6","Patient 7","Patient 8","Patient 9","Patient 10"]
["Patient","Patient Name/ID"]
[null,"Age"]
[null,"Gender"]
["Antibiotic Choice & Duration","Antibiotic Name"]
[null,"Who initiated prophylactic therapy?"]
[null,"Start Date  "]
[null,"Is Review/Stop date documented?"]
[null,"Is review overdue? (>6mths)"]
[null,"Most recent renal function result (eGFR/CrCL) (Note: Nitrofurantoin is contraindicated in eGFR <45mL/min)"]
[null,"Has resistance been identified to the prophylactic agent \nduring the course of therapy? (Review MSU results)"]
[null,"Has patient had any breakthrough \nUTIs while on prophylaxis?"]
[null,"Has the patient an indwelling catheter in-situ? "]
["Outcomes & Action","Comment/Additional info"]
[null,"Action Required?"]
[null,"Action Taken?                                                  (Outline what actions you have taken/plan to take)"]
[null,null,"Are there changes you can implement in your practice to improve UTI prophylactic practices in the future"]

{"sheet":"Data Dashboard","index":1,"n_rows":21,"n_cols":13,"rows_kept":21,"cut":false,"hidden":false,"merged":[[4,1,4,3],[7,1,7,3],[8,3,11,3],[0,1,0,12]]}
[null,"Audit of Patients on UTI Prophylaxis"]
[null,"Date",{"$f":"'Data Input'!B3","v":"2021-06-22"}]
[null,null,"n","%"]
[null,"No. of patients included",{"$f":"COUNTIF('Data Input'!$C$4:$L$4,\"<>\"&\"\")","v":0},null,null,"This Practice",{"$f":"COUNTIF('Data Input'!$C$8:$L$8, \"This Practice\")","v":0},null,null,null,null,"Amoxicillin",{"$f":"COUNTIF('Data Input'!$C$7:$L$7,\"Amoxicillin\")","v":0}]
[null,"Gender",null,null,null,"Previous GP",{"$f":"COUNTIF('Data Input'!$C$8:$L$8, \"Previous GP\")","v":0},null,null,null,null,"Cefalexin",{"$f":"COUNTIF('Data Input'!$C$7:$L$7,\"Cefalexin\")","v":0}]
[null,"Male",{"$f":"COUNTIF('Data Input'!$C$6:$L$6,\"Male\")","v":0},{"$f":"C6/(C6+C7)","v":{"$error":"#DIV/0!"}},null,"Urinary Consultant",{"$f":"COUNTIF('Data Input'!$C$8:$L$8, \"Urology Consultant\")","v":0},null,null,null,null,"Trimethoprim",{"$f":"COUNTIF('Data Input'!$C$7:$L$7,\"Trimethoprim\")","v":0}]
[null,"Female",{"$f":"COUNTIF('Data Input'!$C$6:$L$6,\"Female\")","v":0},{"$f":"C7/(C6+C7)","v":{"$error":"#DIV/0!"}},null,"Other Hospital Source",{"$f":"COUNTIF('Data Input'!$C$8:$L$8, \"Other Hospital Source\")","v":0},null,null,null,null,"Nitrofurantoin",{"$f":"COUNTIF('Data Input'!$C$7:$L$7,\"Nitrofurantoin\")","v":0}]
[null,"Age Profile",null,null,null,"Unknown",{"$f":"COUNTIF('Data Input'!$C$8:$L$8, \"Unknown\")","v":0},null,null,null,null,"Other",{"$f":"COUNTIF('Data Input'!$C$7:$L$7,\"Other\")","v":0}]
[null,">85yrs",{"$f":"COUNTIF('Data Input'!$C$5:$L$5,\">84\")","v":0}]
[null,"75-84yrs",{"$f":"COUNTIFS('Data Input'!$C$5:$L$5,\">74\",'Data Input'!$C$5:$L$5,\"<85\")","v":0}]
[null,"65-74yrs",{"$f":"COUNTIFS('Data Input'!$C$5:$L$5,\">64\",'Data Input'!$C$5:$L$5,\"<75\")","v":0}]
[null,"<65yrs",{"$f":"COUNTIF('Data Input'!$C$5:$L$5,\"<65\")","v":0}]
[]
[null,null,null,null,null,null,null,null,null,null,null,"Action required"]
[null,null,"Action recommended","No action necessary",null,null,null,null,null,null,"Action required",{"$f":"COUNTIF('Data Input'!$C$17:$L$17,\"Yes\")","v":0}]
[null,"Review/Stop date documented",{"$f":"COUNTIF('Data Input'!$C$10:$L$10,\"Yes\")","v":0},{"$f":"COUNTIF('Data Input'!$C$10:$L$10,\"No\")","v":0},null,null,null,null,null,null,"No action required",{"$f":"COUNTIF('Data Input'!$C$17:$L$17,\"No\")","v":0}]
[null,"Review overdue >6mths",{"$f":"COUNTIF('Data Input'!$C$11:$L$11,\"Yes\")","v":0},{"$f":"COUNTIF('Data Input'!$C$11:$L$11,\"No\")","v":0}]
[null,"Resistance identified",{"$f":"COUNTIF('Data Input'!$C$13:$L$13,\"Yes\")","v":0},{"$f":"COUNTIF('Data Input'!$C$13:$L$13,\"No\")","v":0}]
[null,"Breakthrough infection",{"$f":"COUNTIF('Data Input'!$C$14:$L$14,\"Yes\")","v":0},{"$f":"COUNTIF('Data Input'!$C$14:$L$14,\"No\")","v":0}]
[null,"Patient catheterised",{"$f":"COUNTIF('Data Input'!$C$15:$L$15,\"Yes\")","v":0},{"$f":"COUNTIF('Data Input'!$C$15:$L$15,\"No\")","v":0}]
[null,"Nitrofurantoin in renal impairment",{"$f":"COUNTIFS('Data Input'!$C$7:$L$7,\"Nitrofurantoin\",'Data Input'!$C$12:$L$12,\"<45\")","v":0},{"$f":"COUNTIFS('Data Input'!$C$7:$L$7,\"Nitrofurantoin\",'Data Input'!$C$12:$L$12,\">=45\")","v":0}]

{"sheet":"Good Practice Points","index":2,"n_rows":25,"n_cols":1,"rows_kept":25,"cut":false,"hidden":false,"merged":[]}
[]
["Good practice points regarding UTI prophylaxis:"]
["To complete this audit cycle you should repeat after 6 months to demonstrate the improvements made e.g. 100% of patients now have review/stop date documented."]
[]
["ᵒDefinition of recurrent UTI: Recurrent UTI in adults is defined as 2 or more UTIs in the last 6 months or 3 or more UTIs in the last 12 months."]
[]
["ᵒEvaluation of clinical features of recurrent UTIs should include sending a mid-stream urine (MSU) sample for culture."]
[]
["ᵒSpecialist opinion should be considered for patients with recurrent UTI. In particular, it is advisable to refer men, pregnant women and children under 16 for specialist opinion. Antimicrobial prophylaxis should only be considered in these groups following specialist advice."]
[]
["ᵒThe patient should be advised upon initiation that antibiotic prophylaxis is prescribed for a fixed period of time, that there is a risk of side effects and that this is not intended to be  a long-term medication."]
[]
["ᵒIn patients with an identifiable trigger (e.g. sexual intercourse), single-dose prophylaxis (e.g. post-coital) is as effective as \ncontinuous prophylaxis in preventing recurrent UTI, but with fewer side-effects, and should thus be the preferred option."]
[]
["ᵒRecurrent lower urinary tract symptoms are often NOT due to infection, and it is important to consider other diagnoses (e.g. sexually-transmitted infections, postmenopausal atrophic vaginitis, vulvovaginal candidiasis, vulval lichen sclerosis, psoriasis or other dermatological conditions,\nvulvodynia), to avoid unnecessary antibiotic exposure."]
[]
["ᵒAntibiotic prophylaxis is generally not appropriate for the prevention of UTI in catheterised patients because of limited benefit and the risk of antibiotic-associated harm to the patient. "]
["Reviewing UTI prophylaxis"]
["ᵒLong-term nitrofurantoin use is associated with multiple adverse effects, including liver damage, pulmonary fibrosis and peripheral neuropathy. \nIf patients are on nitrofurantoin for longer than 6 months additional monitoring may be required for these conditions and treatment should be withdrawn if they emerge."]
[]
["ᵒAlways review antimicrobial prophylaxis at 3- 6 months, with a view to stopping. "]
[]
["ᵒThere is limited evidence of any additional benefit from such prophylaxis beyond 3-6 months but there is significant evidence of harm."]
[]
["ᵒPatients who have any breakthrough infections or with urine cultures confirming resistance to the prophylactic agent, should have their prophylaxis stopped (exposure to antibiotic without benefit) and a clinical review to discuss ongoing management and/or need for referral."]