Management of urinary tract infections in female general practice patients.

Abstract:

BACKGROUND:Though guidelines for the management of urinary tract infections (UTI) exist in several European countries, little is known about GPs' adherence, and the appropriateness of their management with regard to antibiotic resistance. OBJECTIVES:To describe German GPs' management of female patients with symptoms of UTI, to assess the diagnostic accuracy of dipsticks in a German general practice setting, to develop diagnostic prediction rules for culture-confirmed UTI, and to compare the adequacy of empirical treatment strategies and GPs' actual prescriptions. METHODS:In 36 (of 118 invited) teaching general practices, urine cultures and resistance testing were performed during 4 months on all symptomatic patients. GPs completed a questionnaire on each patients' symptoms, risk factors and treatment. Adequacy of different treatment approaches was calculated based on culture results. RESULTS:445 adult women (76% of all patients) were included, with a median age of 53 years. Complicating factors were present in 27%. Urine culture revealed UTI in 77%. GPs' diagnostic accuracy, using both dipsticks and clinical impressions, was low. A positive nitrite test, dysuria and older age were the only predictive factors of culture-confirmed UTI, however the negative predictive value of dipsticks is low (35%). Empirical treatment of all symptomatic patients with either nitrofurantoin or fluoroquinolones would result in a higher rate of appropriate therapies than the individualized approach chosen by the GPs. CONCLUSION:Most patients with urinary symptoms were not treated according to current guidelines, and GPs' diagnostic and therapeutic accuracy was low. Empirical treatment of all symptomatic patients is probably the most effective policy, but implies unnecessary antibiotic prescriptions.

journal_name

Fam Pract

journal_title

Family practice

authors

Hummers-Pradier E,Ohse AM,Koch M,Heizmann WR,Kochen MM

doi

10.1093/fampra/cmh720

subject

Has Abstract

pub_date

2005-02-01 00:00:00

pages

71-7

issue

1

eissn

0263-2136

issn

1460-2229

pii

cmh720

journal_volume

22

pub_type

杂志文章
  • Diagnosing cancer in the bush: a mixed-methods study of symptom appraisal and help-seeking behaviour in people with cancer from rural Western Australia.

    abstract:BACKGROUND:Previous studies have focused on the treatment received by rural cancer patients and have not examined their diagnostic pathways as reasons for poorer outcomes in rural Australia. OBJECTIVES:To compare and explore symptom appraisal and help-seeking behaviour in patients with breast, lung, prostate or colore...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cms087

    authors: Emery JD,Walter FM,Gray V,Sinclair C,Howting D,Bulsara M,Bulsara C,Webster A,Auret K,Saunders C,Nowak A,Holman CD

    更新日期:2013-06-01 00:00:00

  • Diagnostic performance of retinal digital photography for diabetic retinopathy screening in primary care.

    abstract:Introduction:We must study alternatives to structure an effective diabetic retinopathy screening program for Brazilian public health system. Objectives:Evaluate the diagnostic performance of retinal digital photography for diabetic retinopathy screening in primary care, accuracy of the family physician in diabetic ret...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmx020

    authors: Rosses APO,Ben ÂJ,Souza CF,Skortika A,Araújo AL,Carvalho G,Locatelli F,Neumann CR

    更新日期:2017-09-01 00:00:00

  • The effectiveness of waiting room notice-boards as a vehicle for health education.

    abstract::To determine whether patients read and remembered health promotion messages displayed in waiting rooms, 600 patients in a UK general practice were given a self-complete questionnaire. Two notice-boards carried between 1 to 4 topics over four study periods. Three-hundred and twenty-seven (55%) of subjects responded. Tw...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/11.3.292

    authors: Wicke DM,Lorge RE,Coppin RJ,Jones KP

    更新日期:1994-09-01 00:00:00

  • Detection of emotional problems in the primary care clinic.

    abstract::Emotional problems are an important component of general morbidity in primary care settings. Research on the sensitivity of primary care physicians to such problems is, however, scanty. This study examines the prevalence of emotional problems among 776 patients in primary care clinics in Israel using the GHQ-28 and as...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/7.3.195

    authors: Shiber A,Maoz B,Antonovsky A,Antonovsky H

    更新日期:1990-09-01 00:00:00

  • The uses and abuses of meta-analysis.

    abstract::Meta-analysis is a quantitative process of summary and interpretation which involves pooling information from independent studies concerning a single theme in order to draw conclusions. Greatly increased employment of meta-analysis is currently being advocated for clinical and policy decision making. However, the pres...

    journal_title:Family practice

    pub_type: 杂志文章,评审

    doi:10.1093/fampra/13.4.397

    authors: Charlton BG

    更新日期:1996-08-01 00:00:00

  • Mapping primary health care renewal in South America.

    abstract:BACKGROUND:Primary health care (PHC) renewal processes are currently ongoing in South America (SA), but their characteristics have not been systematically described. OBJECTIVE:The study aimed to describe and contrast the PHC approaches being implemented in SA to provide knowledge of current conceptions, models and cha...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmw013

    authors: Acosta Ramírez N,Giovanella L,Vega Romero R,Tejerina Silva H,de Almeida PF,Ríos G,Goede H,Oliveira S

    更新日期:2016-06-01 00:00:00

  • Assessing family history of heart disease in primary care consultations: a qualitative study.

    abstract:BACKGROUND:Current primary prevention guidelines recommend the assessment of family history of coronary heart disease (CHD) to identify at-risk individuals. OBJECTIVE:To examine how clinicians and patients understand and communicate family history in the context of CHD risk assessment in primary care. METHODS:A quali...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmm037

    authors: Hall R,Saukko PM,Evans PH,Qureshi N,Humphries SE

    更新日期:2007-10-01 00:00:00

  • Analysis of the enablers of capacities to produce primary health care-based reforms in Latin America: a multiple case study.

    abstract:BACKGROUND:Primary health care (PHC)-based reforms have had different results in Latin America. Little attention has been paid to the enablers of collective action capacities required to produce a comprehensive PHC approach. OBJECTIVE:To analyse the enablers of collective action capacities to transform health systems ...

    journal_title:Family practice

    pub_type: 杂志文章,多中心研究

    doi:10.1093/fampra/cmw038

    authors: Báscolo EP,Yavich N,Denis JL

    更新日期:2016-06-01 00:00:00

  • Promoting influenza vaccination of elderly patients in primary care.

    abstract:BACKGROUND:Though influenza is a serious health problem for elderly people, their influenza vaccination rate remains low in Switzerland. OBJECTIVE:Our aim was to assess the impact of an intervention combining multiple strategies to promote influenza vaccination of elderly patients in primary care. METHODS:We conducte...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/19.4.383

    authors: Humair JP,Buchs CR,Stalder H

    更新日期:2002-08-01 00:00:00

  • Substitution scenario in follow-up of chronic cancer patients in primary care: prevalence, disease duration and estimated extra consultation time.

    abstract:BACKGROUND:The incidence of cancer as well as survival rates for it are increasing. It is debated whether care in the chronic phase of cancer can be positioned in primary care due to doubts about capacity and workload. OBJECTIVE:To estimate GPs' extra consultation time if they assume responsibility for the care in the...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmv098

    authors: van Dipten C,Olde Hartman TC,Biermans MC,Assendelft WJ

    更新日期:2016-02-01 00:00:00

  • Is statistician involvement as co-author associated with reduced time to publication of quantitative research in general medical journals? A bibliometric study.

    abstract:OBJECTIVE:We aimed to compare the number of submissions until acceptance and the time to publication between articles co-authored and articles not co-authored by statisticians. METHODS:We randomly selected 781 articles published in 2016 in 18 high impact factor journals of general internal medicine and primary care. F...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmy115

    authors: Sebo P,Fournier JP,Maisonneuve H

    更新日期:2019-07-31 00:00:00

  • Identifying patients who access musculoskeletal physical therapy: a retrospective cohort analysis.

    abstract:BACKGROUND:Musculoskeletal conditions are common and cause high levels of disability and costs. Physical therapy is recommended for many musculoskeletal conditions. Past research suggests that referral rates appear to have increased over time, but the rate of accessing a physical therapist appears unchanged. OBJECTIVE...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmaa104

    authors: Sharpe JA,Martin BI,Fritz JM,Newman MG,Magel J,Vanneman ME,Thackeray A

    更新日期:2020-10-12 00:00:00

  • Paired interviews of shared experiences around chronic low back pain: classic mismatch between patients and their doctors.

    abstract:BACKGROUND:current treatments for chronic low back pain (LBP) appear to be inadequate and there are growing calls for new approaches. This study explores the paired interviews of shared experiences among chronic LBP patients and their physicians with the ultimate goal of improving doctor-patient communication and clini...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmq063

    authors: Allegretti A,Borkan J,Reis S,Griffiths F

    更新日期:2010-12-01 00:00:00

  • Medical and lay views of irritable bowel syndrome.

    abstract:OBJECTIVES:The purpose of this study was to investigate doctors' and patients' views of irritable bowel syndrome (IBS) in order to assess why problems in the doctor-IBS patient relationship seem to occur. METHODS:A qualitative study was undertaken involving in-depth, semi-structured interviews that were tape-recorded,...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/17.2.108

    authors: Dixon-Woods M,Critchley S

    更新日期:2000-04-01 00:00:00

  • Economic evaluation of early administration of prednisolone and/or aciclovir for the treatment of Bell's palsy.

    abstract:OBJECTIVES:Bell's palsy (BP), which causes facial paralysis, affects 11-40 people per 100 000 per annum in the UK. Its cause is unknown but as many as 30% of patients have continuing facial disfigurement, psychological difficulties and occasionally facial pain. We present an randomised controlled trial (RCT)-based econ...

    journal_title:Family practice

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1093/fampra/cmn107

    authors: Hernández RA,Sullivan F,Donnan P,Swan I,Vale L,BELLS Trial Group.

    更新日期:2009-04-01 00:00:00

  • Qualitative research and the problem of judgement: lessons from interviewing fellow professionals.

    abstract:BACKGROUND:Qualitative research methods are recognized increasingly as valuable tools for primary care research, and add an extra dimension to quantitative work. OBJECTIVE:The aim of this study was to illustrate the benefits and problems attending the dual role of clinician/qualitative researcher. METHODS:As part of ...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/19.3.285

    authors: Chew-Graham CA,May CR,Perry MS

    更新日期:2002-06-01 00:00:00

  • South Asian patients' views and experiences of clinical trial participation.

    abstract:OBJECTIVES:This paper explores South Asian patients' views and experiences of clinical trial participation, as part of a larger study which sought to assess British South Asian under-representation in clinical trials. METHODS:The study was based on semi-structured interviews with South Asian trial participants in prim...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmh611

    authors: Hussain-Gambles M

    更新日期:2004-12-01 00:00:00

  • Obstacles to shared care for patients with dementia: a qualitative study.

    abstract:BACKGROUND:All Primary Care Trusts in England were meant to have shared care protocols for antidementia medication use in place by 1 April 2004. Shared care of medical treatment in dementia depends upon early diagnosis, but under-recognition of and under-response to dementia appear widespread in general practice. AIM:...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmi116

    authors: Iliffe S,Wilcock J,Haworth D

    更新日期:2006-06-01 00:00:00

  • Supporting GPs whose performance gives cause for concern: the North Trent experience.

    abstract:BACKGROUND:The North Trent scheme to address the problem of GPs whose performance gives cause for concern was implemented in 1997. This paper describes the structure and process of the scheme and evaluates the main outcomes. METHODS:We used non-participant observation and semi-structured interviews with representative...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/18.2.123

    authors: Joesbury H,Mathers N,Lane P

    更新日期:2001-04-01 00:00:00

  • Aspirin after myocardial infarction: the importance of over-the-counter use.

    abstract:BACKGROUND:Regular aspirin is beneficial after myocardial infarction (MI). Community-based surveys appear to show unsatisfactory uptake of aspirin after MI. This could be due to over-the-counter (OTC) use not being recorded. In a pilot study in one practice, 39% of patients on aspirin after MI used OTC preparations. In...

    journal_title:Family practice

    pub_type: 杂志文章,多中心研究

    doi:

    authors: Hopper S,Pierce M

    更新日期:1998-04-01 00:00:00

  • Anxiety and depression in general practitioners: associations with type of practice, fundholding, gender and other personal characteristics.

    abstract:BACKGROUND:There is evidence both that a doctor's own well-being is closely associated with efficiency and positive attitude to patients, and that levels of stress, anxiety and depression in doctors are rising. OBJECTIVES:This postal survey aimed to measure anxiety and depression levels in general practitioners in 199...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:

    authors: Chambers R,Campbell I

    更新日期:1996-04-01 00:00:00

  • Consultations involving people with congenital disabilities: factors that help or hinder giving care.

    abstract:BACKGROUND:Previous studies have suggested that the attitudes of health professionals towards people with disability may be as negative as those of society. Further, even positive attitudes may not always be reflected in the health professional's behaviour. OBJECTIVE:The aim of this study was to examine GPs' (registra...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/18.4.419

    authors: Muir EH,Ogden J

    更新日期:2001-08-01 00:00:00

  • Prevalence of pre-diabetes in young Mexican adults in primary health care.

    abstract:BACKGROUND:Pre-diabetes in young people is frequently unrecognized or not treated on time, with the consequent loss of opportunity for diabetes prevention. In Mexico, there is scarce information about the prevalence of pre-diabetes in young adults. OBJECTIVE:To determine the prevalence and risk factors for pre-diabete...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmu047

    authors: Ureña-Bogarín EL,Martínez-Ramírez HR,Torres-Sánchez JR,Hernández-Herrera A,Cortés-Sanabria L,Cueto-Manzano AM

    更新日期:2015-04-01 00:00:00

  • Weight gain among women in the late reproductive years.

    abstract:BACKGROUND:Given the impact of obesity on mortality and morbidity in women, we evaluated correlates of weight gain in women ages 35-47 years. METHODS:Three hundred and thirty-six African American and Caucasian American women, randomly selected from among urban residents aged 35-47 years and pre-menopausal at baseline,...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmg411

    authors: Sammel MD,Grisso JA,Freeman EW,Hollander L,Liu L,Liu S,Nelson DB,Battistini M

    更新日期:2003-08-01 00:00:00

  • Why do mothers consult when their children cough?

    abstract::Mothers' beliefs and evaluations of their child's illness were studied in a group of 30 mothers who had consulted a general practitioner because of a cough. Data were collected by tape-recorded semi-structured interviews conducted in their own homes. A major concern for mothers was their fear that their child was goin...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/10.2.193

    authors: Cornford CS,Morgan M,Ridsdale L

    更新日期:1993-06-01 00:00:00

  • Organizing palliative care for rural populations: a systematic review of the evidence.

    abstract:BACKGROUND:Palliative care services have developed mostly in urban areas. Rural areas typically are characterized by the lack of well-organized services, with primary care professionals, specifically GPs and community nurses, having to undertake most of the palliative care. Little is known, however, either of their vie...

    journal_title:Family practice

    pub_type: 杂志文章,评审

    doi:10.1093/fampra/cmg312

    authors: Evans R,Stone D,Elwyn G

    更新日期:2003-06-01 00:00:00

  • Who do we discharge from renal clinic and what does it mean for primary care?

    abstract:BACKGROUND:It is unclear whether discharging patients from renal clinic to primary care is safe. AIM:To determine the characteristics, primary care monitoring and renal outcomes of patients discharged from renal clinic. DESIGN AND SETTING:A retrospective study of 2236 adults discharged from a tertiary renal clinic be...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmz055

    authors: Pyart R,Lim S,Hussein B,Riley S,Roberts G

    更新日期:2020-03-25 00:00:00

  • Effects of a health activist course on knowledge and awareness of antibiotic use.

    abstract::A cohort study investigated the specific outcomes of a health education coursed carried out by recently graduated physicians in an urban primary care setting in Israel. Questionnaires were used to study the effects of the programme on knowledge and awareness concerning antibiotic usage. The results showed a significan...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/6.1.27

    authors: Hermoni D,Friedman M,Morel D,Mankuta D,Sivan A,Porter B

    更新日期:1989-03-01 00:00:00

  • An international perspective on the cholesterol debate.

    abstract::For the past 5 years there has been an intensive debate and a number of conflicting guidelines suggesting what general practitioners (GPs) should do to screen and manage hyperlipidaemia. At a WONCA seminar in Vancouver in 1992, policies and guidelines from Canada, the UK, The Netherlands, New Zealand, Hong Kong and th...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/10.4.431

    authors: Rosser WW,Palmer WH,Fowler G,Lamberts H,Thomson A,Lam C,Frame PS

    更新日期:1993-12-01 00:00:00

  • Maintained effect of a training program on attitudes towards depression in family physicians.

    abstract:Background:Family doctors' (FD) attitudes likely play an important role in the recognition and management of depression. Objective:The purpose of the study was to prospectively analyse the short-term and long-term impact of a specifically designed training program on attitudes towards depression among FDs. Methods:A ...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmx071

    authors: Manzanera R,Lahera G,Álvarez-Mon MÁ,Alvarez-Mon M

    更新日期:2018-01-16 00:00:00