790. Can Electronic Clinical Decision Support Systems Improve the Diagnosis of Urinary Tract Infections?: A Systematic Review and Meta-Analysis

Abstract Background Urinary tract infection (UTI) is a commonly misdiagnosed infectious condition. Stewardship interventions which successfully reduce rates of asymptomatic bacteriuria treatment (ASB) are often labor intensive, and thus systematic solution desirable. In this study, our objective was to systematically review studies evaluate the effect implementing clinical decision support system on ordering urine culture tests for diagnosis UTI across diverse settings. Methods We conducted comprehensive electronic search 5 databases manual reference list peer-reviewed articles published prior July 2, 2021. Studies described an intervention designed unnecessary or incorrect through utilization CDS were included. The primary outcome interest rate ordered. Two investigators independently screened extracted compiled data. Results A total 5,013 screened, 14 met inclusion criteria (Table 1). most common urinalysis with reflex based pre-specified parameters, such as threshold level pyuria. All 9 statistical comparisons reported decreased post-intervention, 8 statistically significant 2). Overall, 37% decrease in detected after implementation 3). Several also improvements antimicrobial-related measures days therapy guideline-concordant therapy. Catheter-associated urinary 2 unchanged 1 study. limited number included no adverse outcomes including increased bloodstream mortality rates. Conclusion Electronic systems appear be effective decreasing improving diagnosis. Prospective needed impact antimicrobial prescribing, patient-relevant outcomes, potential effects. Disclosures Elie Saade, MD, MPH, Janssen: Advisor/Consultant Curtis Donskey, Pfizer, Clorox, Ecolab, Professional Disposables International: Grant/Research Support Abhishek Deshpande, PhD, Clorox: Support|Merck & Co., Inc., Kenilworth, NJ, USA: Advisor/Consultant|Merck Stocks/Bonds|Seres Therapeutics: Support.