[Diagnostic and therapeutic management of urinary infections. Survey in the medical services of the hospitals south of the Marseille Hospital Center].
OBJECTIVE
The aim of this prospective study was to observe diagnostic and antibiotic prescribing practices in urinary tract infection disease (UTID) in comparison with available guidelines.


METHODS
We included all patients hospitalized in four medical wards of the Sainte-Marguerite Hospital in Marseille France who suffered from UTID.


RESULTS
During the study period, 60 cases of UTID were observed, 29 were community-acquired and 31 were nosocomially-acquired. Management of uncomplicated UTID, the most frequent type (47/60 cases), showed considerable divergence between practices and guidelines. Not in keeping with the guidelines, urinalysis reagent strips were only used for 3 of the 47 cases. Furthermore, broad-spectrum antibiotics were prescribed as the first line treatment in more than 70% of the patients whereas only half of these prescriptions were warranted according to the guidelines. For complicated UTID however (13 cases) diagnostic and antibiotic prescribing practices were globally in accordance with the guidelines.


CONCLUSIONS
This survey points out the divergence between guidelines and real management of UTID in hospitals. Clinical practices should be revisited to be in agreement with guidelines. Drafting antibiotic prescription guides explaining UTID management would be helpful for training future physicians.
Villani
P
P
Service de Médecine interne et Thérapeutique, Hôpital Sainte Marguerite, Marseille. pvillani@ap-hm.fr
Demet
D
D
Ambrosi
P
P
Brondino-Riquier
R
R
Bouvenot
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000628:therapy; D003428:Cross Infection / Q000175:diagnosis / Q000628:therapy; D005260:Female; D019983:Guideline Adherence; D019538:Health Care Surveys; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D011934:Reagent Strips; D012307:Risk Factors; D014546:Urinary Catheterization; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000628:therapy
D011934:Reagent Strips