{
  "id": "medical/antibiotic-course-duration-shortening",
  "signature": "AI recommends a 7-day course of antibiotics for uncomplicated urinary tract infection (UTI) in a non-pregnant adult female, exceeding the recommended 3-5 day course and increasing resistance risk",
  "signature_zh": "AI 推荐非妊娠成年女性无并发症尿路感染 (UTI) 使用 7 天抗生素疗程，超过推荐的 3-5 天，增加耐药风险",
  "regex": "(UTI|urinary\\s*tract|cystitis).*(7\\s*day|seven\\s*day|10\\s*day|14\\s*day)",
  "domain": "medical",
  "category": "data_error",
  "subcategory": null,
  "root_cause": "Current IDSA guidelines for uncomplicated UTI in non-pregnant women recommend 3-5 days of nitrofurantoin or 3 days of TMP-SMX, not 7 days. Longer courses increase antibiotic resistance, adverse effects, and cost without improving cure rates.",
  "root_cause_type": "generic",
  "root_cause_zh": "当前 IDSA 指南推荐非妊娠女性无并发症 UTI 使用呋喃妥因 3-5 天或 TMP-SMX 3 天，而非 7 天。较长疗程增加抗生素耐药、不良反应和成本，而不提高治愈率。",
  "versions": [
    {
      "version": "UpToDate 2023.5",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "Sanford Guide 2023",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "Epic Antibiotic Stewardship v2.1",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    }
  ],
  "os_specific": {},
  "dead_ends": [
    {
      "action": "Always prescribe 7 days 'to be safe' because some patients have resistant organisms",
      "why_fails": "Routine 7-day courses select for resistant organisms; guidelines recommend 3-5 days for uncomplicated UTI, with 7 days reserved for complicated or pyelonephritis cases",
      "fail_rate": 0.75,
      "condition": "",
      "sources": []
    },
    {
      "action": "Prescribe 10 days of amoxicillin-clavulanate because it covers more bacteria",
      "why_fails": "Amoxicillin-clavulanate has higher resistance rates for E. coli (the most common UTI pathogen) compared to nitrofurantoin or TMP-SMX, and longer duration increases C. diff risk",
      "fail_rate": 0.65,
      "condition": "",
      "sources": []
    },
    {
      "action": "Use a 5-day course of ciprofloxacin because it's broad spectrum",
      "why_fails": "Ciprofloxacin is a fluoroquinolone with significant side effects (tendon rupture, QT prolongation) and should be reserved for complicated UTI or when other options are not available; 3-day course is sufficient for uncomplicated UTI if used",
      "fail_rate": 0.8,
      "condition": "",
      "sources": []
    }
  ],
  "workarounds": [
    {
      "action": "Implement guideline-based order sets: For uncomplicated UTI in non-pregnant female, default to nitrofurantoin 100 mg BID x 5 days. Add a hard stop: if duration >5 days, require indication (e.g., 'complicated UTI', 'pyelonephritis', 'male'). Example order: 'Nitrofurantoin 100 mg PO BID x 5 days'",
      "success_rate": 0.9,
      "how": "Implement guideline-based order sets: For uncomplicated UTI in non-pregnant female, default to nitrofurantoin 100 mg BID x 5 days. Add a hard stop: if duration >5 days, require indication (e.g., 'complicated UTI', 'pyelonephritis', 'male'). Example order: 'Nitrofurantoin 100 mg PO BID x 5 days'",
      "condition": "",
      "sources": []
    },
    {
      "action": "Add antibiotic stewardship alert: when duration exceeds guideline, display: 'IDSA recommends 3-5 days for uncomplicated UTI. Longer courses increase resistance and adverse effects. Please confirm indication.'",
      "success_rate": 0.85,
      "how": "Add antibiotic stewardship alert: when duration exceeds guideline, display: 'IDSA recommends 3-5 days for uncomplicated UTI. Longer courses increase resistance and adverse effects. Please confirm indication.'",
      "condition": "",
      "sources": []
    }
  ],
  "workarounds_zh": [
    "Implement guideline-based order sets: For uncomplicated UTI in non-pregnant female, default to nitrofurantoin 100 mg BID x 5 days. Add a hard stop: if duration >5 days, require indication (e.g., 'complicated UTI', 'pyelonephritis', 'male'). Example order: 'Nitrofurantoin 100 mg PO BID x 5 days'",
    "Add antibiotic stewardship alert: when duration exceeds guideline, display: 'IDSA recommends 3-5 days for uncomplicated UTI. Longer courses increase resistance and adverse effects. Please confirm indication.'"
  ],
  "transition_graph": {
    "leads_to": [],
    "preceded_by": [],
    "frequently_confused_with": []
  },
  "official_doc_url": "https://www.idsociety.org/practice-guideline/uti/",
  "official_doc_section": null,
  "error_code": "MED-ABX-003",
  "verification_tier": "ai_generated",
  "confidence": 0.86,
  "fix_success_rate": 0.8,
  "resolvable": "true",
  "first_seen": "2023-07-12",
  "last_confirmed": "2024-06-01",
  "last_updated": "2024-06-01",
  "evidence_count": 1,
  "tags": [],
  "locale": "en",
  "aliases": []
}