Trial reportThe British journal of general practice : the journal of the Royal College of General Practitioners2018
Point-of-care urine culture for managing urinary tract infection in primary care: a randomised controlled trial of clinical and cost-effectiveness.
Trial report in The British journal of general practice : the journal of the Royal College of General Practitioners, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Point-of-care tests for urinary tract infections to reduce antimicrobial resistance: a systematic review and conceptual economic model.Health technology assessment (Winchester, England) · 2024Pooled it
- Cost-effectiveness of point-of-care diagnostics for AMR: a systematic review.The Journal of antimicrobial chemotherapy · 2024Pooled it
- Economic evaluation of antimicrobial stewardship in primary care: a systematic review and quality assessment.The Journal of antimicrobial chemotherapy · 2022Pooled it
- Trial
- A new point-of-care test for the rapid detection of urinary tract infections.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2020Trial
- Identification of clinical and urine biomarkers for uncomplicated urinary tract infection using machine learning algorithms.Scientific reports · 2019Trial
- Diagnostic tests for urinary tract infections and antimicrobial resistance-a reality check between diagnostic innovation and implementation: a critical narrative review.Frontiers in cellular and infection microbiology · 2026Review
- Application and evaluation of HB&L system in the rapid diagnosis of urinary tract infection.Translational andrology and urology · 2025Article
- Rapid diagnosis of urinary tract infection with miniaturised point-of-care cultivation on a dipstick.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Review
- Antibiotic prescribing intensity and community UTI resistance: a cross-sectional ecological study.BJGP open · 2025Article
- Article
- Article
- Performance of an innovative culture-based digital dipstick for detection of bacteriuria.Microbiology spectrum · 2024Article
- Increased demand of urine cultures from Danish general practice: a five-year register-based study.Scandinavian journal of primary health care · 2023Article
- A systematic review of the outcomes reported in the treatment of uncomplicated urinary tract infection clinical trials.JAC-antimicrobial resistance · 2022Review
- A systematic review investigating the use of microbiology outcome measures in randomized controlled trials evaluating antimicrobial stewardship interventions published between 2011 and 2021.JAC-antimicrobial resistance · 2022Review
- Use and quality of point-of-care microscopy, urine culture and susceptibility testing for urinalysis in general practice.Scandinavian journal of primary health care · 2022Article
- How Accurate Are Veterinary Clinicians Employing Flexicult Vet for Identification and Antimicrobial Susceptibility Testing of Urinary Bacteria?Antibiotics (Basel, Switzerland) · 2021Article
- Diagnosis and Management of UTI in Primary Care Settings-A Qualitative Study to Inform a Diagnostic Quick Reference Tool for Women Under 65 Years.Antibiotics (Basel, Switzerland) · 2020Article
- Antibiotic procurement and ABC analysis for a comprehensive primary health care clinic in the Eastern Cape province, South Africa.Southern African journal of infectious diseases · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe effectiveness of using point-of-care (POC) urine culture in primary care on appropriate antibiotic use is unknown.
aimTo assess whether use of the Flexicult DESIGN AND
settingIndividually randomised trial of females with uncomplicated urinary tract infection (UTI) in primary care research networks (PCRNs) in England, the Netherlands, Spain, and Wales.
methodMultilevel regression compared outcomes between the two groups while controlling for clustering.
resultsIn total, 329 participants were randomised to POC testing (POCT) and 325 to standard care, and 324 and 319 analysed. Fewer females randomised to the POCT arm than those who received standard care were prescribed antibiotics at the initial consultation (267/324 [82.4%] versus 282/319 [88.4%], odds ratio [OR] 0.56, 95% confidence interval [CI] = 0.35 to 0.88). Clinicians indicated the POCT result changed their management for 190/301 (63.1%). Despite this, there was no statistically significant difference between study arms in antibiotic use that was concordant with laboratory culture results (primary outcome) at day 3 (39.3% POCT versus 44.1% standard care, OR 0.84, 95% CI = 0.58 to 1.20), and there was no evidence of any differences in recovery, patient enablement, UTI recurrences, re-consultation, antibiotic resistance, and hospitalisations at follow-up. POCT culture was not cost-effective.
conclusionPoint-of-care urine culture was not effective when used mainly to adjust immediate antibiotic prescriptions. Further research should evaluate use of the test to guide initiation of 'delayed antibiotics'.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.