[Do urocultures change our therapy approach?].
OBJECTIVE
To describe to what extent the results of urocultures modify approaches to therapy and the factors linked to this change.


METHODS
Cross-sectional, descriptive study by means of review of records.


METHODS
Primary care.


METHODS
222 adult urocultures requested at 8 health centres between March and May 1999.


METHODS
We extracted from the records age, sex, symptoms, risk factors, and approach to therapy before and after the uroculture. We discarded 358 urocultures because of not finding the clinical record or because the episode or data on the change in approach to therapy was lacking in the record.


RESULTS
The urocultures belonged to patients with a mean age of 54.2, 73.1% of whom were women. 34.7% presented no risk factor for UTI. 44% had no symptoms of UTI. 21.2% of urocultures were positive, with E. coli the most frequently isolated bacteria (69.4%). Empirical antibiotic treatment was called for in 44.6% (70.1% quinolones, 9.3% fosfomycin). After receipt of the result, there was a change of approach in 25 cases (11.4%, SE 2.1%), of whom 15 did not receive empirical treatment (6 with symptoms and 9 without). The antibiotic was changed in 9 of the 99 cases treated empirically (always because of resistance). Among those with change of approach, there was a higher percentage of risk factors (84% against 62%, p < 0.05, chi 2 = 4.47). There were no differences for age, sex, symptoms or bacteria between the two groups.


CONCLUSIONS
There is a quite considerable percentage of urocultures that lead to a change in approach to therapy, although most of the patients had linked risk factors and/or did not receive empirical antibiotic treatment.
Centro de Salud Sta. M. de Benquerencia, Gerencia de AP de Toledo.
M J
MJ
Piñero Acín
M R
MR
Martínez Matías
M J
MJ
Córdoba Gutiérrez
T
T
Sánchez Rojas
D
D
López Juárez
F J
FJ
Rodríguez Alcalá
D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D014552:Urinary Tract Infections / Q000382:microbiology*; D014556:Urine / Q000382:microbiology*