title: Can we improve adherence to guidelines for the treatment of lower urinary tract infection? A simple, multifaceted intervention in out-of-hours services.
abstract: OBJECTIVE
  To improve antimicrobial prescribing behaviour of general practitioners in large-scale out-of-hours services for uncomplicated lower urinary tract infection (LUTI) in females aged 20-80 years, which is regarded as one of the most prevalent bacterial infections in primary care.
  
  
  METHODS
  A quasi-experimental design was used in two regional large-scale out-of-hours services. A simple, multifaceted intervention was offered in a 16 week period in one region (the intervention region). During the two washout periods, at 5 and 17 months, we observed diagnoses and prescriptions. The main outcome measure was the share of appropriate and inappropriate prescriptions.
  
  
  RESULTS
  The proportion of patients with LUTI ranged from 1.0% to 2.1%. The relative proportion of appropriate prescriptions in the intervention region increased from 26.9% to 69.4%, but decreased afterwards to 40.8%.
  
  
  CONCLUSIONS
  A simple, multifaceted intervention for treatment of LUTI during out-of-hours care may improve the quality of antimicrobial prescribing, although the improvement may not be sustained in the longer term.
authors.affiliation: General Practice, Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences,   University of Antwerp, Universiteitsplein 1, 2610 Wlrijk Antwerp,  Belgium.
authors.forename: Leentje
authors.initials: L
authors.lastname: Willems
authors.forename: Pieter
authors.initials: P
authors.lastname: Denckens
authors.forename: Hilde
authors.initials: H
authors.lastname: Philips
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Henriquez
authors.forename: Roy
authors.initials: R
authors.lastname: Remmen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000592:standards*; D005260:Female; D058006:General Practice / Q000379:methods; D019983:Guideline Adherence; D006801:Humans; D008875:Middle Aged; D014552:Urinary Tract Infections / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents