Navigating reflex urine culture practices in community hospitals: Need for a validated approach.

• Reflex urine cultures (RUC) may be beneficial as a diagnostic stewardship intervention when used appropriately. • While RUC can decrease identification of bacteriuria, it may not improve diagnosis of urinary tract infections, unless targeted to symptomatic patients. • Implementation of RUC in community hospitals poses unique opportunities and challenges. • Future research should identify ideal urinalysis parameters and specific patient populations that safely benefit from RUC strategies. We performed a descriptive study of reflex urine culture (RUC) practices across 51 community hospitals in southeastern United States. We found that 26 unique reflexing criteria were used in 28 hospitals. Only 14% hospitals of hospitals that offered RUC restricted it to specific populations (eg, emergency room). Our data suggest that the current RUC approach in community hospitals warrants further validation of urinalysis criteria and identification of specific populations in which RUC performs best. [ABSTRACT FROM AUTHOR]