Variation by specialty in the treatment of urinary tract infection in women.
To determine practicing physicians' strategies for diagnosing and managing uncomplicated urinary tract infection, we surveyed physicians in general internal medicine, family practice, obstetrics and gynecology, and emergency medicine in four states. Responses differed significantly by respondents' specialty. For example, nitrofurantoin was the antibiotic of first choice for 46% of obstetricians, while over 80% in the other specialties chose trimethoprim-sulfamethoxazole. Most surveyed said they do not usually order urine culture, but the percentage who do varied by specialty. Most use a colony count of 10(5) colony-forming units or more for diagnosis although evidence favors a lower threshold, and 70% continue antibiotic therapy even if the culture result is negative. This survey found considerable variation by specialty and also among individual physicians regarding diagnosis and treatment of urinary tract infection and also suggests that some of the new information from the literature has not been translated to clinical practice.
Wigton
R S
RS
Department of Internal Medicine, University of Nebraska Medical Center College of Medicine, Omaha, USA.
Longenecker
J C
JC
Bryan
T J
TJ
Parenti
C
C
Flach
S D
SD
Tape
T G
TG
D000328:Adult; D000892:Anti-Infective Agents, Urinary / Q000627:therapeutic use*; D003625:Data Collection; D005260:Female; D006801:Humans; D008511:Medicine; D009582:Nitrofurantoin / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013038:Specialization; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D014481:United States; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000188:drug therapy*
D000892:Anti-Infective Agents, Urinary; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D009582:Nitrofurantoin