Evidence map›Paper›PMID 33167875›Full record

Observational studyBMC infectious diseases2020

Management of urinary tract infections: what do doctors recommend and patients do? An observational study in German primary care.

Ildikó Gágyor, Stephanie Strube-Plaschke, Katrin Rentzsch, Wolfgang Himmel

Abstract readObservational Study
In one paragraph

Observational study in BMC infectious diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Ildikó GágyorDepartment of General Practice, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2/D7, 97080, Würzburg, Germany. Gagyor_I@ukw.de.ORCID https://orcid.org/0000-0002-7974-7603
Stephanie Strube-PlaschkeDepartment of General Practice, Göttingen University Medical Center, Humboldtallee 38, 37073, Göttingen, Germany.ORCID https://orcid.org/0000-0002-1643-3025
Katrin RentzschDepartment of Psychology, Psychologische Hochschule Berlin, Am Köllnischen Park 2, 10179, Berlin, Germany.ORCID https://orcid.org/0000-0001-8632-6842
Wolfgang HimmelDepartment of General Practice, Göttingen University Medical Center, Humboldtallee 38, 37073, Göttingen, Germany.ORCID https://orcid.org/0000-0003-3523-5486

Funding

German Federal Ministry of Education and Research (BMBF) 01KG1105
6 · The paper itself

Abstract

backgroundUncomplicated urinary tract infections (UTIs) in women are usually managed in primary care with antibiotics. However, many women seem to prefer to handle UTI symptoms with nonsteroidal anti-inflammatory drugs (NSAIDs) and other remedies. The aim of this study was to compare UTI management as recommended by physicians with the patients' management at home.

methodsThis prospective cohort study in German primary care is based on clinical data from local practices and patient questionnaires. Participating women completed a baseline data sheet in the practice; their urine sample was tested by a dipstick in the practice and cultured by a laboratory. The women reported treatment and symptom-related impairment on an eight-item symptom questionnaire daily for 7 days. Using growth curve models, we analysed the influence of time on the total severity score to examine how symptoms changed across days. We then examined whether symptom severity and symptom course differed between patients who took antibiotics or NSAIDs.

resultsA total of 120 women (mean age of 43.3 ± 16.6 years) were enrolled. The urine dipstick was positive for leucocytes in 92%, erythrocytes in 87%, and nitrites in 23%. Physicians prescribed antibiotics for 102 (87%) women and recommended NSAIDs in 14 cases. According to the women's reports, only 60% (72/120) took antibiotics, while the remainder took NSAIDs and other remedies. Symptoms declined from day 0 to day 6, irrespective of whether women decided to take an antibiotic, NSAIDs, none or both, as confirmed by a significant curvilinear time effect (B = 0.06, SE = 0.005, p < .001). The symptom course, however, was moderated by taking antibiotics so that the change in symptom severity was somewhat more pronounced in women taking antibiotics (B = 0.06) than in the remainder (B = 0.04).

conclusionA substantial proportion of women did not follow their physicians' treatment recommendations, and many used NSAIDs. All women had a good chance of recovery irrespective of whether they decided to take antibiotics. A sensitive listening to patient preferences in the consultation may encourage physicians to recommend and prescribe symptomatic treatment with NSAID more often than antibiotic medicines.

Indexed as

Primary Health CareReferral and ConsultationAdultAnti-Bacterial AgentsAnti-Inflammatory Agents, Non-SteroidalDrug Resistance, BacterialEscherichia coliEscherichia coli InfectionsFemaleHumansMiddle AgedPatient CompliancePhysiciansProspective StudiesSurveys and QuestionnairesUrinary Tract InfectionsAnti-Bacterial AgentsAnti-Inflammatory Agents, Non-SteroidalAnti bacterial agentsNon-steroidal anti-inflammatory agentsPrimary health careProspective studiesQuality of lifeSurveys and questionnairesSymptom assessmentUrinary tract infection

Identifiers

PMID33167875
PMCPMC7650164

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Registered trials

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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.