GPs' treatment of uncomplicated urinary tract infections--a clinical judgement analysis in four European countries. DEP group. Drug Education Project.
BACKGROUND
Non-adherence to recommendations for treatment of uncomplicated urinary tract infections (UTI) is common, but the reasons are not sufficiently understood.


OBJECTIVE
We aimed to assess and compare the influence of specific patient characteristics on GPs' treatment decisions for UTI in four European countries.


METHODS
GPs in The Netherlands, Norway, Sweden and Germany were presented 18-26 case vignettes of UTI. Linear regression models were used to determine which patient characteristics predicted non-optimal decisions.


RESULTS
Adherence to national recommendations varied both within and between countries, but there were remarkable similarities in the case characteristics predicting non-optimal decisions: a history of UTI and the patient's age were strongly related to prescription of second-choice antibiotics and longer treatment courses.


CONCLUSIONS
In all countries many GPs were reluctant to follow the recommendations in UTI cases that they might perceive as being more complicated.
Hummers-Pradier
E
E
Department of General Practice, University of Göttingen, Germany.
Denig
P
P
Oke
T
T
Lagerløv
P
P
Wahlström
R
R
Haaijer-Ruskamp
F M
FM
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002983:Clinical Competence / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000592:standards / Q000639:trends; D005194:Family Practice / Q000592:standards* / Q000639:trends; D005260:Female; D005858:Germany; D019538:Health Care Surveys; D006801:Humans; D007600:Judgment; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009664:Norway; D010818:Practice Patterns, Physicians'; D012720:Severity of Illness Index; D013548:Sweden; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000503:physiopathology
D000900:Anti-Bacterial Agents