The adherence of GPs to guidelines for the diagnosis and treatment of lower urinary tract infections in women is poor.
OBJECTIVE
To assess the adherence of GPs to evidence-based guidelines for the diagnosis and management of lower urinary tract infection (UTI) in women.


METHODS
A cross-sectional study was performed from March to July 2009 in primary care offices. Physicians consecutively registered the first six UTI attended during an 8-week period. Age, days with symptoms, episode of infection, associated morbidity, signs and symptoms, diagnostic procedures performed, antibiotic prescription, allergies and referral or not were registered. The type of antibiotic course (short or long) and first-choice treatments were also taken into account.


RESULTS
Of 176 physicians invited to participate, 110 (62.5%) included 658 women with lower UTI. Urine dipstick was performed in 550 cases (83.6%) and urine culture was requested in 235 women (35.7%), with criteria for culture in 49.6% and without criteria in 32.8%. Antibiotic treatment was administered in 634 cases (96.4%). Short courses were given to 385 women (60.7%) and 75 of those with complicated UTI were treated with long courses (66.4%). First-choice antibiotics were administered as empiric treatment in only 92 women with uncomplicated UTI (17.7%).


CONCLUSIONS
These results highlight the poor adherence of GPs to the current recommendations of clinical practice guidelines with a high number of inappropriate urine cultures requested and a low utilization of first-choice antibiotics.
Primary Care Centre Jaume I, University Rovira i Virgili, Tarragona, Spain. carles.llor@urv.cat
Carl
C
Llor
Gloria
G
Rabanaque
Ana
A
López
Josep Maria
JM
Cots
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D058005:General Practitioners; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D013030:Spain; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000188:drug therapy*
D000900:Anti-Bacterial Agents