{
  "id": "medical/antibiotic-uti-duration",
  "signature": "AI recommends a 7-day course of antibiotics for uncomplicated urinary tract infection (UTI) in a non-pregnant adult female, ignoring guideline-recommended 3-5 day course",
  "signature_zh": "AI推荐非妊娠成年女性无并发症尿路感染使用7天抗生素疗程，忽略指南推荐的3-5天疗程",
  "regex": "7.*day.*antibiotic.*UTI|UTI.*course.*7.*day|uncomplicated.*UTI.*duration.*7",
  "domain": "medical",
  "category": "health_risk",
  "subcategory": null,
  "root_cause": "IDSA guidelines recommend 3-5 days of nitrofurantoin or TMP-SMX for uncomplicated UTI in non-pregnant women; longer courses increase antibiotic resistance, side effects, and cost without improving cure rates.",
  "root_cause_type": "generic",
  "root_cause_zh": "IDSA指南推荐非妊娠女性无并发症尿路感染使用呋喃妥因或TMP-SMX治疗3-5天；更长疗程会增加抗生素耐药性、副作用和成本，而不会提高治愈率。",
  "versions": [
    {
      "version": "IDSA UTI Guidelines 2023",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "EPIC UTI Order Set v4.2",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "CDC Antibiotic Stewardship Toolkit v2.0",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    }
  ],
  "os_specific": {},
  "dead_ends": [
    {
      "action": "7-day course is safer to ensure eradication",
      "why_fails": "Studies show 3-5 days is equally effective for uncomplicated UTI; longer courses increase selection for resistant organisms and adverse effects like C. diff colitis",
      "fail_rate": 0.85,
      "condition": "",
      "sources": []
    },
    {
      "action": "Use 7 days for all UTIs regardless of gender or pregnancy",
      "why_fails": "Men, pregnant women, and complicated UTIs require longer courses; but for non-pregnant women, shorter is better. Failing to differentiate leads to overtreatment",
      "fail_rate": 0.8,
      "condition": "",
      "sources": []
    },
    {
      "action": "Extend to 10 days if symptoms persist after 3 days",
      "why_fails": "Persistent symptoms after 3 days may indicate a resistant organism or complicated UTI; extending the same antibiotic blindly is not recommended; culture and sensitivity should be done",
      "fail_rate": 0.75,
      "condition": "",
      "sources": []
    }
  ],
  "workarounds": [
    {
      "action": "For uncomplicated UTI in non-pregnant adult women, prescribe nitrofurantoin 100 mg BID for 5 days OR TMP-SMX DS BID for 3 days (if local resistance <20%). Example: Prescribe nitrofurantoin 100 mg twice daily for 5 days. Do not extend beyond 5 days unless culture shows resistance.",
      "success_rate": 0.92,
      "how": "For uncomplicated UTI in non-pregnant adult women, prescribe nitrofurantoin 100 mg BID for 5 days OR TMP-SMX DS BID for 3 days (if local resistance <20%). Example: Prescribe nitrofurantoin 100 mg twice daily for 5 days. Do not extend beyond 5 days unless culture shows resistance.",
      "condition": "",
      "sources": []
    },
    {
      "action": "Use a clinical decision support tool in the EHR (e.g., EPIC UTI order set) that defaults to guideline-recommended durations and flags deviations.",
      "success_rate": 0.88,
      "how": "Use a clinical decision support tool in the EHR (e.g., EPIC UTI order set) that defaults to guideline-recommended durations and flags deviations.",
      "condition": "",
      "sources": []
    },
    {
      "action": "For patients with recurrent UTI, obtain a urine culture before starting antibiotics to guide targeted therapy, rather than empiric extended courses.",
      "success_rate": 0.85,
      "how": "For patients with recurrent UTI, obtain a urine culture before starting antibiotics to guide targeted therapy, rather than empiric extended courses.",
      "condition": "",
      "sources": []
    }
  ],
  "workarounds_zh": [
    "对于非妊娠成年女性的无并发症尿路感染，处方呋喃妥因100 mg 每日两次，疗程5天；或TMP-SMX DS 每日两次，疗程3天（若当地耐药率<20%）。例如：处方呋喃妥因100 mg 每日两次，共5天。除非培养显示耐药，否则不要延长疗程。",
    "在电子健康记录中使用临床决策支持工具（例如 EPIC UTI 医嘱集），该工具默认采用指南推荐的疗程并标记偏差。",
    "对于复发性尿路感染患者，在开始抗生素治疗前获取尿培养以指导靶向治疗，而非经验性延长疗程。"
  ],
  "transition_graph": {
    "leads_to": [],
    "preceded_by": [],
    "frequently_confused_with": []
  },
  "official_doc_url": "https://www.idsociety.org/practice-guideline/urinary-tract-infection/",
  "official_doc_section": null,
  "error_code": "IDSA-UTI-2023",
  "verification_tier": "ai_generated",
  "confidence": 0.88,
  "fix_success_rate": 0.92,
  "resolvable": "true",
  "first_seen": "2023-10-01",
  "last_confirmed": "2024-06-01",
  "last_updated": "2024-06-01",
  "evidence_count": 1,
  "tags": [],
  "locale": "en",
  "aliases": []
}