title: A survey of primary care physician practices in antibiotic prescribing for the treatment of uncomplicated male gonoccocal urethritis.
abstract: BACKGROUND
  The development of resistance to antimicrobial therapy by Neisseria gonorrhoeae causes on-going problems for individual case management of gonorrhoea. Surveillance data about N. gonorrhoeae have indicated an increase in the incidence of gonorrhoea in France in 2006. As a consequence of the development of antibiotic resistance in N. gonorrhoeae, French guidelines excluded fluoroquinolones as a standard treatment for N. gonorrhoeae. Ceftriaxone became the recommended treatment, associated with azithromycin for Clamydia trachomatis infection. Our aim was to describe the practice patterns of general practitioners (GPs) in managing the antibiotic treatment of patients with symptoms suggestive of uncomplicated male urethritis.
  
  
  METHODS
  We developed a clinical vignette describing a man with typical gonococcal urethritis symptoms to elicit questions about antibiotic treatment. We mailed the electronic questionnaire to a random sample of 1000 French GPs belonging to the Sentinelles Network.
  
  
  RESULTS
  By the end of the survey period, 350 vignettes were received, yielding a response rate of 35%. Sixty-six GPs (20.2%) prescribed the recommended antibiotics for the simultaneous treatment of N. gonorrhoeae and C. trachomatis infections, while 132 GPs (40.4%) prescribed only non-recommended antibiotics, including ciprofloxacin in 69 cases (21.1%). General practitioners with less than 10 years in practice showed better compliance to guidelines than those with more years in practice (p<0.05).
  
  
  CONCLUSIONS
  The results suggest a mismatch between the guidelines and the antibiotic treatment of male uncomplicated urethritis by French GPs, mostly among the subgroup of physicians who have been in practice longer. Educational approaches based on practice feedback need to be developed to improve these deficits in the quality of care.
authors: INSERM, UMPC UMR-S 707, F-75012, Paris, France. falchi@u707.jussieu.fr
authors: Alessandra
authors: A
authors: Falchi
authors: Andrea
authors: A
authors: Lasserre
authors: Anne
authors: A
authors: Gallay
authors: Thierry
authors: T
authors: Blanchon
authors: Patrice
authors: P
authors: Sednaoui
authors: François
authors: F
authors: Lassau
authors: Veronique
authors: V
authors: Massari
authors: Clément
authors: C
authors: Turbelin
authors: Thomas
authors: T
authors: Hanslik
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