The diagnosis of urinary tract infection: a systematic review.

Abstract:

BACKGROUND:Urinary tract infections (UTI) are among the leading reasons for treatment in adult primary care medicine, accounting for a considerable percentage of antibiotic prescriptions. Because this problem is so common and so significant in routine clinical practice, a high level of diagnostic accuracy is essential. Antibiotics should not be prescribed excessively, particularly in view of the increasing prevalence of antibiotic resistance. METHOD:Systematic review of relevant articles that were retrieved by a search of the Medline, Embase, and Cochrane Library databases. The recommendations of selected international guidelines were also taken into account, as were the German national quality standards for microbiological diagnosis. RESULTS:The diagnosis of UTI by clinical criteria alone has an error rate of approximately 33%. The use of refined diagnostic algorithms does not completely eliminate uncertainty. CONCLUSION:With the aid of a small number of additional diagnostic criteria, antibiotic treatment for UTI can be provided more specifically and thus more effectively. Differentiating UTI from asymptomatic bacteriuria, which usually requires no treatment, can lower the frequency of unnecessary antibiotic prescriptions.

journal_name

Dtsch Arztebl Int

authors

Schmiemann G,Kniehl E,Gebhardt K,Matejczyk MM,Hummers-Pradier E

doi

10.3238/arztebl.2010.0361

subject

Has Abstract

pub_date

2010-05-01 00:00:00

pages

361-7

issue

21

issn

1866-0452

journal_volume

107

pub_type

杂志文章,评审
  • Long-term opioid use in non-cancer pain.

    abstract:BACKGROUND:The long-term use of opioid analgesic drugs to treat chronic non-cancer pain (CNCP) is a major component of pain pharmacotherapy. The interpretation of the evidence concerning its efficacy and risks is currently debated. METHODS:An interdisciplinary evidence- and consensus-based S3 guideline was updated on ...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2014.0732

    authors: Häuser W,Bock F,Engeser P,Tölle T,Willweber-Strumpfe A,Petzke F

    更新日期:2014-10-24 00:00:00

  • Non-vitamin K Antagonist Oral Anticoagulants (NOAC) as an Alternative Treatment Option in Tumor-Related Venous Thromboembolism.

    abstract:BACKGROUND:The risk of venous thromboembolism (VTE) is 4 to 7 times higher in cancer patients than in the normal population. Moreover, cancer patients who take anticoagulants suffer more frequently from hemorrhagic complications and VTE recurrences. Patients often find low-molecular-weight heparin (LMWH) treatment unpl...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2019.0031

    authors: Beyer-Westendorf J,Klamroth R,Kreher S,Langer F,Matzdorff A,Riess H

    更新日期:2019-01-18 00:00:00

  • Deployment-related stress disorder in german soldiers: utilization of psychiatric and psychotherapeutic treatment.

    abstract:INTRODUCTION:Military missions abroad carry a high risk of psychological traumatization. In this study, we examined the reasons for increased utilization of the treatments offered to soldiers by the German armed forces' psychiatric services. METHOD:We analyzed trends in initial contacts with psychiatrists and psychoth...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2012.0569

    authors: Kowalski JT,Hauffa R,Jacobs H,Höllmer H,Gerber WD,Zimmermann P

    更新日期:2012-09-01 00:00:00

  • Dextromethorphan withdrawal and dependence syndrome.

    abstract:BACKGROUND:The N-methyl-D-aspartate (NMDA) antagonist dextromethorphan has been available in pharmacies without a prescription since 1954 as an antitussive agent. There is an alarming increase in reports of its abuse. Dextromethorphan is avidly taken, mainly by young people, as a psychoactive drug. The currently availa...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2010.0537

    authors: Mutschler J,Koopmann A,Grosshans M,Hermann D,Mann K,Kiefer F

    更新日期:2010-07-01 00:00:00

  • Oral Anticoagulation.

    abstract:BACKGROUND:Much new evidence on oral anticoagulation has come to light in recent years. Non-vitamin-K-dependent oral anti- coagulants (NOAC) have been developed and have been introduced into clinical practice. In this review, we present the current state of the evidence on anticoagulation for various indications with v...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2018.0776

    authors: Altiok E,Marx N

    更新日期:2018-11-16 00:00:00

  • Red Eye: A Guide for Non-specialists.

    abstract:BACKGROUND:Red eye can arise as a manifestation of many different systemic and ophthalmological diseases. The physician whom the patient first consults for this problem is often not an ophthalmologist. A correct assessment of the urgency of the situation is vitally important for the planning of further diagnostic evalu...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2017.0302

    authors: Frings A,Geerling G,Schargus M

    更新日期:2017-04-28 00:00:00

  • Interprofessional Medication Management in Patients With Multiple Morbidities.

    abstract:BACKGROUND:Medication reviews and medication management are being used more and more around the world to improve medication safety. Both of these tools were originally conceived as pharmaceutical care activities and have recently been developed into interdisciplinary approaches. We studied the efficacy of interprofessi...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,随机对照试验

    doi:10.3238/arztebl.2016.0741

    authors: Köberlein-Neu J,Mennemann H,Hamacher S,Waltering I,Jaehde U,Schaffert C,Rose O

    更新日期:2016-11-04 00:00:00

  • Familial hypercholesterolemia: developments in diagnosis and treatment.

    abstract:BACKGROUND:Familial hypercholesterolemia (FH) is a congenital disorder of lipid metabolism characterized by a marked elevation of the plasma concentration of LDL (low-density lipoprotein) cholesterol beginning in childhood and by the early onset of coronary heart disease. It is among the commonest genetic disorders, wi...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2014.0523

    authors: Klose G,Laufs U,März W,Windler E

    更新日期:2014-08-04 00:00:00

  • Polar body biopsy in the diagnosis of monogenic diseases: the birth of three healthy children.

    abstract:BACKGROUND:For prospective parents at risk of transmitting a monogenic disease, polar body analysis is an option for pre-conception genetic diagnosis. In Germany, polar body analysis is currently performed in only two centers (Lübeck and Regensburg). METHODS:The authors present a clinical series of 9 couples at risk f...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2009.0533

    authors: Griesinger G,Bündgen N,Salmen D,Schwinger E,Gillessen-Kaesbach G,Diedrich K

    更新日期:2009-08-01 00:00:00

  • QTc prolongation by psychotropic drugs and the risk of Torsade de Pointes.

    abstract:INTRODUCTION:Many psychotropic drugs can delay cardiac repolarization and thereby prolong the rate-corrected QT interval (QTc). A prolonged QTc often arouses concern in clinical practice, as it can be followed, in rare cases, by the life-threatening polymorphic ventricular tachyarrhythmia called torsade de pointes (TdP...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2011.0687

    authors: Wenzel-Seifert K,Wittmann M,Haen E

    更新日期:2011-10-01 00:00:00

  • Cerebral Amyloid Angiopathy in Stroke Medicine.

    abstract:BACKGROUND:Cerebral amyloid angiopathy (CAA) is a degenerative vasculopathy that is classically associated with lobar intracerebral or sulcal hemorrhage. Its prevalence is estimated at 30% in the seventh decade and 50% in the eighth and ninth decades. In this review, we summarize the risks linked to CAA with respect to...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2017.0037

    authors: Block F,Dafotakis M

    更新日期:2017-01-20 00:00:00

  • Preventing postoperative delirium.

    abstract:BACKGROUND:Delirium is a common complication in elderly hospitalized patients. It prolongs the length of hospital stay, raises costs, increases the workload of the nursing staff, and may necessitate transfer of the patient to a nursing home. The risk of postoperative delirium is particularly high in elderly patients wi...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2015.0289

    authors: Kratz T,Heinrich M,Schlauß E,Diefenbacher A

    更新日期:2015-04-24 00:00:00

  • Durability of bioprosthetic cardiac valves.

    abstract:INTRODUCTION:The choice of type of heart valve prosthesis is determined by the patient's age since bioprostheses have a limited lifespan. This article reviews current recommendations and the literature on cardiac valve replacement. METHODS:Selective literature search in Medline/PubMed back to 1996 and review of curren...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2008.0143

    authors: Hoffmann G,Lutter G,Cremer J

    更新日期:2008-02-01 00:00:00

  • The Pathology of Severe COVID-19-Related Lung Damage.

    abstract:BACKGROUND:The histomorphological changes of lung damage in severe coronavirus disease 2019 (COVID-19) have not yet been adequately characterized. In this article, we describe the sequence of pathological changes in COVID-19 and discuss the implications for approaches to treatment. METHODS:Standardized autopsies were ...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2020.0500

    authors: Kommoss FKF,Schwab C,Tavernar L,Schreck J,Wagner WL,Merle U,Jonigk D,Schirmacher P,Longerich T

    更新日期:2020-07-20 00:00:00

  • Internet- Based Interventions in Chronic Somatic Disease.

    abstract:BACKGROUND:Clinical guidelines recommend psychosocial care as an integral part of medical treatment, but access is often limited. Technology-based approaches provide an attractive opportunity to optimize health outcomes and quality of life in people with chronic somatic diseases e.g. by means of Internet- and mobile-ba...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2018.0659

    authors: Bendig E,Bauereiß N,Ebert DD,Snoek F,Andersson G,Baumeister H

    更新日期:2018-11-05 00:00:00

  • Intrauterine surgery--choices and limitations.

    abstract:BACKGROUND:The past decade has seen much progress in intrauterine surgery. Randomized trials have documented the benefit of some procedures of this type for the unborn child. METHOD:Selective literature review RESULTS:Randomized trials have demonstrated the benefit of fetoscopic laser coagulation of placental anastom...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2012.0603

    authors: Diemert A,Diehl W,Glosemeyer P,Deprest J,Hecher K

    更新日期:2012-09-01 00:00:00

  • The management of psychiatric emergencies.

    abstract:BACKGROUND:Psychiatric emergencies such as acute psychomotor agitation or suicidality often arise in non-psychiatric settings such as general hospitals, emergency services, or doctors' offices and give rise to stress for all persons involved. They may be life-threatening and must therefore be treated at once. In this a...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2011.0222

    authors: Mavrogiorgou P,Brüne M,Juckel G

    更新日期:2011-04-01 00:00:00

  • The etiology, diagnosis and prevention of liver cirrhosis: part 1 of a series on liver cirrhosis.

    abstract:BACKGROUND:Cirrhosis of the liver is the end stage of chronic liver disease. Among the many liver disorders that can lead to cirrhosis, some progress rapidly (years) and others more slowly (decades). In Germany, cirrhosis is often a consequence of fatty liver disease due to alcoholism or other causes, but can also be c...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2013.0085

    authors: Wiegand J,Berg T

    更新日期:2013-02-01 00:00:00

  • Outpatient Antibiotic Prescription.

    abstract:BACKGROUND:In view of the rise in antibiotic resistance and Clostridium difficile superinfection, close monitoring of antibiotic prescribing practices is essential so that targeted quality assurance measures can be taken. METHODS:We analyzed nationwide data from multiple statutory health insurance carriers on prescrip...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2016.0454

    authors: Bätzing-Feigenbaum J,Schulz M,Schulz M,Hering R,Kern WV

    更新日期:2016-07-01 00:00:00

  • Ovarian cancer: diagnosis and treatment.

    abstract:BACKGROUND:Patients with ovarian cancer usually present to a family physician with nonspecific symptoms, most often abdominal pain. The outcome depends above all on the stage of the disease when it is diagnosed and on the quality of treatment. METHODS:This article is based on a review of selected publications from 200...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2011.0635

    authors: Burges A,Schmalfeldt B

    更新日期:2011-09-01 00:00:00

  • Treatment of depressive disorders.

    abstract:INTRODUCTION:A confusing variety of options are available for the treatment of depressive disorders. METHOD:Selective literature review under consideration of current guidelines. RESULTS:The treatment of depression can be divided into acute, maintenance and prophylactic phases. The basic forms of treatment are pharma...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2008.0782

    authors: Bschor T,Adli M

    更新日期:2008-11-01 00:00:00

  • The treatment of colorectal carcinoma with monoclonal antibodies: the importance of KRAS mutation analysis and EGFR status.

    abstract:BACKGROUND:The epidermal growth factor receptor (EGFR) is an important target in the treatment of metastatic colorectal carcinoma (mCRC). The combination of anti-EGFR antibodies with chemotherapy has led to a higher response rate of certain kinds of tumor as well as a significant prolongation of the progression-free in...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2009.0202

    authors: Stintzing S,Heinemann V,Moosmann N,Hiddemann W,Jung A,Kirchner T

    更新日期:2009-03-01 00:00:00

  • Hormonal therapy in the elderly prostate cancer patient.

    abstract:BACKGROUND:Prostatic cancer (PCa) is the most common cancer in men in Germany. The goal of this review is to define the indication for hormonal treatment in patients over age 70. METHODS:A selective search of the literature up to 2008 for the terms "prostate cancer", "androgen suppression and deprivation", "hormone th...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,meta分析,评审

    doi:10.3238/arztebl.2009.0242

    authors: Pfitzenmaier J,Altwein JE

    更新日期:2009-04-01 00:00:00

  • Atraumatic Femoral Head Necrosis in Adults.

    abstract:BACKGROUND:Atraumatic necrosis of the femoral head is a common cause of hip arthrosis in middle age. In Germany, it affects 5000-7000 patients per year, corresponding to an incidence of 0.01%. Though rarer than primary hip arthrosis, it is still of major clinical and socio-economic significance. Patients with this prob...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,meta分析,评审

    doi:10.3238/arztebl.2016.0031

    authors: Arbab D,König DP

    更新日期:2016-01-22 00:00:00

  • Judging a plethora of p-values: how to contend with the problem of multiple testing--part 10 of a series on evaluation of scientific publications.

    abstract:BACKGROUND:When reading reports of medical research findings, one is usually confronted with p-values. Publications typically contain not just one p-value, but an abundance of them, mostly accompanied by the word "significant." This article is intended to help readers understand the problem of multiple p-values and how...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2010.0050

    authors: Victor A,Elsässer A,Hommel G,Blettner M

    更新日期:2010-01-01 00:00:00

  • Idiopathic scoliosis.

    abstract:BACKGROUND:Scoliosis is a three-dimensional deviation of the spinal axis. The main diagnostic criterion is spinal curvature exceeding 10° on a plain anteroposterior X-ray image. Scoliosis is called idiopathic when no other underlying disease can be identified. METHODS:Selective literature review and recommendations of...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,meta分析,评审

    doi:10.3238/arztebl.2010.0875

    authors: Trobisch P,Suess O,Schwab F

    更新日期:2010-12-01 00:00:00

  • The Diagnosis and Treatment of Peripheral Arterial Vascular Disease.

    abstract:BACKGROUND:In peripheral arterial occlusive disease (PAOD), arterial stenosis or occlusion impairs perfusion in the territory of the distal portion of the aorta and the iliac and leg arteries. In Germany, the prevalence of PAOD rises with age, reaching 20% among persons over age 70. METHODS:This guideline was prepared...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,实务指引

    doi:10.3238/arztebl.2016.0729

    authors: Lawall H,Huppert P,Espinola-Klein C,Rümenapf G

    更新日期:2016-10-28 00:00:00

  • Fecal transplant in refractory Clostridium difficile colitis.

    abstract:BACKGROUND:Clostridium difficile infections are becoming more common, more severe, and more likely to recur. Conventional treatment with antibiotics often fails to eradicate the infection; even when it succeeds, recurrent infection is common. Complementary treatment with probiotic agents to reconstitute the physiologic...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2013.0108

    authors: Kleger A,Schnell J,Essig A,Wagner M,Bommer M,Seufferlein T,Härter G

    更新日期:2013-02-01 00:00:00

  • Cluster-Randomized Studies.

    abstract:BACKGROUND:Cluster-randomized trials (CRT) are needed to compare interventions that are allocated to entire groups of subjects, rather than to individuals. Publications about CRT have become steadily more common over the past decade. Readers of such publications should be able to categorize and interpret the findings o...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章,评审

    doi:10.3238/arztebl.2018.0163

    authors: Lorenz E,Köpke S,Pfaff H,Blettner M

    更新日期:2018-03-09 00:00:00

  • Vitamin and Mineral Status in a Vegan Diet.

    abstract:BACKGROUND:In Germany, public interest in a vegan diet is steadily growing. There are, however, no current data on the macro- and micronutrient status of vegans. METHODS:In a cross-sectional study entitled "The Risks and Benefits of a Vegan Diet" (RBVD), we investigated the dietary intake, basic laboratory parameters,...

    journal_title:Deutsches Arzteblatt international

    pub_type: 杂志文章

    doi:10.3238/arztebl.2020.0575

    authors: Weikert C,Trefflich I,Menzel J,Obeid R,Longree A,Dierkes J,Meyer K,Herter-Aeberli I,Mai K,Stangl GI,Müller SM,Schwerdtle T,Lampen A,Abraham K

    更新日期:2020-08-31 00:00:00