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Quality of the Diagnostic Process, Treatment Decision, and Predictors for Antibiotic Use in General Practice for Nursing Home Residents with Suspected Urinary Tract Infection

Urinary tract infections (UTIs) are common in nursing home (NH) residents and Denmark is one of the countries with the highest antibiotic use in NHs. The aim of this study was to assess the quality of the diagnostic process and treatment decision on the day of the first contact from NHs to general p...

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Autores principales: Sommer-Larsen, Stine Dyhl, Arnold, Sif Helene, Holm, Anne, Aamand Olesen, Julie, Cordoba, Gloria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8003235/
https://www.ncbi.nlm.nih.gov/pubmed/33803831
http://dx.doi.org/10.3390/antibiotics10030316
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author Sommer-Larsen, Stine Dyhl
Arnold, Sif Helene
Holm, Anne
Aamand Olesen, Julie
Cordoba, Gloria
author_facet Sommer-Larsen, Stine Dyhl
Arnold, Sif Helene
Holm, Anne
Aamand Olesen, Julie
Cordoba, Gloria
author_sort Sommer-Larsen, Stine Dyhl
collection PubMed
description Urinary tract infections (UTIs) are common in nursing home (NH) residents and Denmark is one of the countries with the highest antibiotic use in NHs. The aim of this study was to assess the quality of the diagnostic process and treatment decision on the day of the first contact from NHs to general practice and assess predictors for prescription of antibiotics in NH residents without an indwelling urinary catheter. The study was a prospective observational study in general practice in the Capital Region of Denmark; 490 patients were included; 158 out of 394 (40.1%, 95% CI 35; 45) patients with suspected UTI had urinary tract symptoms; 270 out of 296 (91.2%, 95% CI 87; 94) patients without urinary tract symptoms had a urine culture performed. Performing urine culture in the general practice was inversely associated to prescription of antibiotics on day one (OR 0.27, 95% CI 0.13; 0.56). It is imperative to support the implementation of interventions aimed at improving the quality of the diagnostic process on day one, as less than half of the patients given the diagnosis “suspected UTI” had urinary tract symptoms, and most patients without urinary tract symptoms had a urine culture performed.
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spelling pubmed-80032352021-03-28 Quality of the Diagnostic Process, Treatment Decision, and Predictors for Antibiotic Use in General Practice for Nursing Home Residents with Suspected Urinary Tract Infection Sommer-Larsen, Stine Dyhl Arnold, Sif Helene Holm, Anne Aamand Olesen, Julie Cordoba, Gloria Antibiotics (Basel) Article Urinary tract infections (UTIs) are common in nursing home (NH) residents and Denmark is one of the countries with the highest antibiotic use in NHs. The aim of this study was to assess the quality of the diagnostic process and treatment decision on the day of the first contact from NHs to general practice and assess predictors for prescription of antibiotics in NH residents without an indwelling urinary catheter. The study was a prospective observational study in general practice in the Capital Region of Denmark; 490 patients were included; 158 out of 394 (40.1%, 95% CI 35; 45) patients with suspected UTI had urinary tract symptoms; 270 out of 296 (91.2%, 95% CI 87; 94) patients without urinary tract symptoms had a urine culture performed. Performing urine culture in the general practice was inversely associated to prescription of antibiotics on day one (OR 0.27, 95% CI 0.13; 0.56). It is imperative to support the implementation of interventions aimed at improving the quality of the diagnostic process on day one, as less than half of the patients given the diagnosis “suspected UTI” had urinary tract symptoms, and most patients without urinary tract symptoms had a urine culture performed. MDPI 2021-03-18 /pmc/articles/PMC8003235/ /pubmed/33803831 http://dx.doi.org/10.3390/antibiotics10030316 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Article
Sommer-Larsen, Stine Dyhl
Arnold, Sif Helene
Holm, Anne
Aamand Olesen, Julie
Cordoba, Gloria
Quality of the Diagnostic Process, Treatment Decision, and Predictors for Antibiotic Use in General Practice for Nursing Home Residents with Suspected Urinary Tract Infection
title Quality of the Diagnostic Process, Treatment Decision, and Predictors for Antibiotic Use in General Practice for Nursing Home Residents with Suspected Urinary Tract Infection
title_full Quality of the Diagnostic Process, Treatment Decision, and Predictors for Antibiotic Use in General Practice for Nursing Home Residents with Suspected Urinary Tract Infection
title_fullStr Quality of the Diagnostic Process, Treatment Decision, and Predictors for Antibiotic Use in General Practice for Nursing Home Residents with Suspected Urinary Tract Infection
title_full_unstemmed Quality of the Diagnostic Process, Treatment Decision, and Predictors for Antibiotic Use in General Practice for Nursing Home Residents with Suspected Urinary Tract Infection
title_short Quality of the Diagnostic Process, Treatment Decision, and Predictors for Antibiotic Use in General Practice for Nursing Home Residents with Suspected Urinary Tract Infection
title_sort quality of the diagnostic process, treatment decision, and predictors for antibiotic use in general practice for nursing home residents with suspected urinary tract infection
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8003235/
https://www.ncbi.nlm.nih.gov/pubmed/33803831
http://dx.doi.org/10.3390/antibiotics10030316
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