title: Effectiveness and safety of telemedical management in uncomplicated urinary tract infections.
abstract: Uncomplicated urinary tract infections (UUTI) in women are frequent reasons for consultations in general practice. We evaluated the effectiveness and safety of telemedical management at a telemedicine centre in Switzerland. Management followed evidence-based protocols, including teleprescription of an antibiotic. Consecutive UUTI patients who had a teleconsultation including the prescription of an antibiotic were followed up three days later about symptom relief, adverse events or the need to visit a doctor. Of a total of 526 eligible women, follow-up information was available for 95%. Three days after teleconsultation, 79% of patients reported complete symptom relief, and 92% reported a reduction of UUTI symptoms. Five percent of patients reported deterioration, e.g. due to an increase of pain, flank pain or fever. Four percent reported side-effects of the prescribed antibiotics. In the three days following teleconsultation, 4% of women consulted another health-care provider without further contacting the telemedicine centre. Another 8% of patients were referred to face-to-face consultation because they developed additional symptoms or because bacterial resistance of the prescribed antibiotic was suspected. Compared to data from the literature on UUTI, evidence-based telemedical management including teleprescription of an antibiotic is as safe and effective as prescriptions initiated by a face-to-face consultation.
authors.affiliation: Gellertstrasse 19, CH-4020 Basel, Switzerland eva.blozik@medgate.ch. eva.blozik@medgate.ch
authors.forename: Eva
authors.initials: E
authors.lastname: Blozik
authors.forename: Carsten
authors.initials: C
authors.lastname: Sommer-Meyer
authors.forename: Manuela
authors.initials: M
authors.lastname: Cerezo
authors.forename: Jan
authors.initials: J
authors.lastname: von Overbeck
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000892:Anti-Infective Agents, Urinary / Q000627:therapeutic use; D055695:Electronic Prescribing; D005260:Female; D006801:Humans; D017060:Patient Satisfaction; D019114:Remote Consultation / Q000458:organization & administration / Q000592:standards*; D013557:Switzerland; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D000892:Anti-Infective Agents, Urinary