An observational study of empirical antibiotics for adult women with uncomplicated UTI in general practice
Open Access
- 21 April 2007
- journal article
- research article
- Published by Oxford University Press (OUP) in Journal of Antimicrobial Chemotherapy
- Vol. 59 (6), 1200-1203
- https://doi.org/10.1093/jac/dkm108
Abstract
ObjectivesWomen presenting in primary care with symptoms suggestive of uncomplicated urinary tract infection (UTI) are commonly managed without urine culture. We therefore do not know how successful general practitioners (GPs) are at targeting antibiotic treatment to women who would have had a microbiologically confirmed UTI, or at avoiding antibiotics in those who would have had a negative culture, had all patients with a suspected UTI been sampled. We therefore explored the association between antibiotic prescribing and urine culture results when culture was performed in all symptomatic patients.MethodsGPs in nine general practices in South Wales were asked to submit urine specimens from all women consulting with clinically suspected, uncomplicated UTI. Patients were followed up 2 weeks later by questionnaire.Results and conclusionsOne hundred and thirteen adult women with a median age of 54 years were included and 61% received empirical antibiotics. There was very low agreement between the decision to prescribe empirically and subsequent culture result (Kappa = 0.04), with 60% of those prescribed empirical antibiotics subsequently found to have a negative culture, and 25% of those found to have a positive culture not prescribed empirical antibiotics. Current strategies to target empirical antibiotic prescribing in clinically suspected, uncomplicated UTI require review.Keywords
This publication has 9 references indexed in Scilit:
- Urinary tract infections in general practice patients: diagnostic tests versus bacteriological cultureJournal of Antimicrobial Chemotherapy, 2006
- Urinary tract infections in women: diagnosis and management in primary careBMJ, 2006
- Response to antibiotics of women with symptoms of urinary tract infection but negative dipstick urine test results: double blind randomised controlled trialBMJ, 2005
- Management of urinary tract infections in female general practice patientsFamily Practice, 2004
- The urine dipstick test useful to rule out infections. A meta-analysis of the accuracyBMC Urology, 2004
- The natural course of uncomplicated lower urinary tract infection in women illustrated by a randomized placebo controlled studyScandinavian Journal of Infectious Diseases, 2004
- Clinical management of urinary tract infection in women: a prospective cohort study.Family Practice, 2003
- Does This Woman Have an Acute Uncomplicated Urinary Tract Infection?Jama-Journal Of The American Medical Association, 2002
- The Impact of Empirical Management of Acute Cystitis on Unnecessary Antibiotic UseArchives of Internal Medicine, 2002