Perceptions and behaviours of infectious diseases physicians when managing urinary tract infections due to MDR organisms.
OBJECTIVE
The objective of this study was to attain a better understanding of infectious diseases (ID) physicians' experience with MDR organism (MDRO) urinary tract infections (UTIs) by means of a survey on disease perception, diagnostic management and treatment preferences.


METHODS
A nine-question survey was developed and distributed to members of the North American Emerging Infections Network (EIN) in September 2013.


RESULTS
Seven hundred and fourteen out of 1461 EIN members responded to the survey (49%). The responses of 603 responders were studied. Most providers perceived an increase in the incidence of MDRO UTIs over the past 3 years (75% of adult ID responders and 63% of paediatric ID responders). One hundred and thirty-four (22%) responders prefer intravenous over oral administration of antimicrobials when both are available, 171 (28%) prefer longer durations of therapy when comparing an MDRO with a susceptible isolate of the same species and 142 (24%) order a repeat urine culture as 'proof of cure' after treating an MDRO UTI. Nevertheless, 530 (88%) responders perceived MDRO UTIs to be of similar severity as non-MDRO UTIs. Fifty-five percent of providers prescribed fosfomycin for MDRO UTI at least once; the most common prescribing pattern (among a wide spectrum of approaches) was a single dose (16%).


CONCLUSIONS
Future studies on MDRO UTIs should clarify the role of resistance in patient outcomes and the comparative efficacy of different antimicrobials. Of particular interest is fosfomycin, which is unrelated to other antibiotic classes and may take a more prominent role in treating MDRO cystitis.
Division of Infectious Diseases, Washington University School of Medicine, 660 S. Euclid, St Louis, MO 63110, USA.
Sergio E
SE
Trevino
Division of Infectious Diseases, Washington University School of Medicine, 660 S. Euclid, St Louis, MO 63110, USA.
Hilary M
HM
Babcock
Division of Infectious Diseases, Washington University School of Medicine, 660 S. Euclid, St Louis, MO 63110, USA.
Jeffrey P
JP
Henderson
Division of Infectious Diseases, Washington University School of Medicine, 660 S. Euclid, St Louis, MO 63110, USA.
Michael A
MA
Lane
Emerging Infections Network, Carver College of Medicine, University of Iowa, 200 Hawkins Dr. SW-34JGH, Iowa City, IA 52242, USA.
Susan E
SE
Beekmann
Emerging Infections Network, Carver College of Medicine, University of Iowa, 200 Hawkins Dr. SW-34JGH, Iowa City, IA 52242, USA.
Philip M
PM
Polgreen
Division of Infectious Diseases, Washington University School of Medicine, 660 S. Euclid, St Louis, MO 63110, USA Department of Infectious Diseases, Inselspital, Bern University Hospital, Friedbühlstrasse 51, Bern 3010, Switzerland jonas.marschall@insel.ch.
Jonas
J
Marschall
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D019090:Case Management; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D009656:North America; D010820:Physicians; D011795:Surveys and Questionnaires; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000188:drug therapy*
D000900:Anti-Bacterial Agents