[Family practice management in urethritis. II. Comparison of clinical management to the protocol].
OBJECTIVE
To describe general practitioners' approach to and management of urethritis in men, and to compare this with a general practice protocol for urethritis.


METHODS
Descriptive.


METHODS
General practices in Amsterdam.


METHODS
In 13 general practices in Amsterdam (23,510 patients, of whom 11,627 men) all episodes of urethritis in men (n = 55) were recorded during one year (complaints, medical management, diagnosis, medication, follow-up).


METHODS
Description of the diagnostic and therapeutic approach and the course of episodes; rough comparison with the urethritis protocol.


RESULTS
In 25% the urine sediment was examined; other office tests were rarely performed. In 30 to 40% out of office microbiological tests were performed. In 50% of new diagnoses medication was underdosed, in some cases medication was wrong or not broad enough. In 25% explicit education was offered. In 22% new medication was given in the follow-up encounter.


CONCLUSIONS
(Comparison with protocol.) Urine sediment examination as an effective test is performed insufficiently often. Other office tests are rarely performed, in accordance with the protocol. Out of office microbiological tests are performed too often, judged by the few changes of diagnosis and the character of new medication in the follow-up. First treatment is often underdosed and sometimes wrong. First treatment should preferably be broad, adequately dosed and independent of out of office microbiology. Too little education is given concerning the risks of ascending infections in female partners and of HIV infection. The referral rate is very low. It is important to pay attention to the outcome of this study in (postgraduate) education for general practitioners, as they treat the vast majority of urethritis patients.
Wigersma
L
L
Universiteit van Amsterdam, vakgroep Huisartsgeneeskunde.
D000892:Anti-Infective Agents, Urinary / Q000008:administration & dosage / Q000627:therapeutic use; D019411:Clinical Laboratory Techniques / Q000379:methods; D002985:Clinical Protocols; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D014526:Urethritis / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control
D000892:Anti-Infective Agents, Urinary
Het huisartsgeneeskundig handelen bij urethritis. II. Toetsing van het medisch handelen aan het protocol.