Observational studyBMC family practice2020
Workload, diagnostic work-up and treatment of urinary tract infections in adults during out-of-hours primary care: a retrospective cohort study.
Observational study in BMC family practice, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 19 citations in OpenAlex.
- Knowledge, attitudes, and practice around urinary tract infections of general practice assistants in the Netherlands: a cross-sectional internet survey.BMC primary care · 2025Article
- Comparing visual and automated urine dipstick analysis in a general practice population.Scandinavian journal of primary health care · 2025Article
- Oral Antibacterial Drug Prescribing in Primary Care Out-of-Hours Services: A Scoping Review.Antibiotics (Basel, Switzerland) · 2025Review
- Urinary tract infections in women in Catalonia, Spain: a population-based observational cohort study in primary care.Frontiers in pharmacology · 2025Article
- Article
- Urinary Tract Infections in Men in Primary Care in Catalonia, Spain.Antibiotics (Basel, Switzerland) · 2023Article
- Patients' Experiences, Expectations, Motivations, and Perspectives around Urinary Tract Infection Care in General Practice: A Qualitative Interview Study.Antibiotics (Basel, Switzerland) · 2023Article
- Antibiotic prescription patterns in patients with suspected urinary tract infections in Ecuador.PloS one · 2023Article
- What is the Diagnostic Accuracy of Novel Urine Biomarkers for Urinary Tract Infection?Biomarker insights · 2023Review
- Patient characteristics and dispatch responses of urinary tract infections in a prehospital setting in Copenhagen, Denmark: a retrospective cohort study.BMC primary care · 2022Observational
- Diagnosis of acute cystitis in primary care: symptom-based versus urinalysis-based diagnosis.Primary health care research & development · 2022Observational
- Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUrinary tract infections (UTIs) are one of the most common infections in primary care. Previous research showed that GPs find it challenging to diagnose UTIs and frequently divert from guidelines leading to unwarranted antibiotic prescriptions and inefficient use of diagnostics such as urinary cultures. We hypothesise that management of UTIs during out-of-hours care may be extra challenging due to a higher workload and logistical issues regarding diagnostic work-up and obtaining results. We therefore aimed to study the workload, diagnostic work-up and treatment of UTIs during out-of-hours primary care.
methodsWe performed a retrospective observational cohort study in which we analysed a full year (2018) of electronic patient records of two large Dutch GP out-of-hours centres. All adult patients with UTI symptoms were included in this study. Descriptive statistics and multivariate regression were used to analyse diagnostics and subsequent management.
resultsA total of 5657 patients were included (78.9% female, mean age of 54 years), with an average of eight patients per day that contact a GP out-of-hours centre because of UTI symptoms. Urinary dipsticks were used in 87.5% of all patients visiting the out-of-hours centres with UTI symptoms. Strikingly, urinary cultures were only requested in 10.3% of patients in which urinary culture was indicated. Seventy-four percent of the patients received antibiotics. Seventy-nine percent of the patients with a negative nitrite test still received antibiotics. Remarkably, patients at risk of complications because of a UTI, such as men, received fewer antibiotic prescriptions.
conclusionsIn total, 74% of the patients received antibiotics. 8 out of 10 patients still received an antibiotic prescription in case of a negative nitrite test, and 9 out of 10 patients with an indication did not receive a urine culture. In conclusion, we found that correctly diagnosing UTIs and prescribing antibiotics for UTIs is a challenge that needs major improvement, especially during out-of-hours GP care.
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