Year: 2003
Type: article
Study design: Observational Study
Abstract: Background: Research on urinary tract infections (UTI) has focussed on women.Little is known about men presenting to their general practitioner (GP) with symptoms of UTI.Methods: In 39 (of 120 invited) teaching general practices, urine cultures and resistance testing were performed during 4 months on all patients presenting with symptoms evoking UTI.Additionally, GPs completed a questionnaire on each patients' symptoms, risk factors and treatment.16% of all patients were men (n=91), their median age was 61 years.Results: Men most often complained of frequent voiding (44%), dysuria (42%), suprapubic or kidney pain (13% each).18% had suffered from previous UTI.One third (38%) had additional risk factors (diabetes 13%, permanent catheter lo%, urinary surgery 7%, renal failure 4%, recent antibiotic treatment 4%).Antibiotics were prescribed for 36% (42% cotrimoxazol, 33% quinolones), mostly for 5-10 days.In 21%, an ultrasound examination was performed, 7% were referred to an urologist and 35% were asked to return for a control.After urine culture, a Vn (210' CFU/ml) was confirmed in 29%, 40% had sterile urine, 31 % 'lowcount'-UTI.E. coli and enterococci were the most common organisms.Resistance levels were high: 53% for amoxycilline and cefaclor, 28% for cefixim, 22% for ciprofloxacin, 34% for trimethoprim and cotrimoxazol, 25% for nitrofurantoin.Conclusion: Men with symptoms evoking UTI were more common in general practice than expected.Only one third of symptomatic men had UTI confirmed by culture.In bacteria causing male UTI, resistance levels were surprisingly high against all common antibiotics.Appropriate management strategies are not sufficiently well defined.Ayranci Unal, Akgun Yurd.iriui.Unluoclu llh.inii.Kireniirci Abdurr.ihm.inO s m ~t i ~m i Ilnrversity -Medic(, Social Center, 26480 Metelrk Ejbiir'hrr.Tirrkey.Phone: +O 222 (42 6 6 0 02 0 1.E -m i r l ; i c r i t i / ' r ! . 1 ~1 1 1 ~1 ~' 7 h 0 0 .' V ~H .Background: Ifpper respir.iroryr r x t inktioris (URTkJ 'ire .I c'oriiriioii presentation re<isoii to prim'iry health c.ire centre$.1nappropri.ite.inrihioriciiw is widespread tor the rre.irnieiit ot tipper respiratory t r x t infections in spite of the lack of benefit in releiving symptoms and preventing complications.Furthermore the resistance of bacteria is a growing public health concern.Objectives: To determine the rate of antibiotic overuse in the treatment of adults with URTIs such as sinusitis; pharyngitis, tonsillitis, common cold infections, with regards to culture resulrs.Methods: The study was conducted at the primary health care (PHC) called Medico-Social Center of Osmangazi University, Eskisehir, Turkey with cases being prescribed antibiotics and followed-up for 12 subsequent weeks between October 1st and December the 31st, 2002.The patients who visited the centre with a main complaint of sore throat, above 16 years of age, irrespective of sex, nationality, marital status, occupation and location, were included.The data were recorded in a previously designed form which included the demographic characteristics, clinical diagnosis, laboratory investigations of the patients.The x' statistical rest was employed in comparing categorical variables.A p value of <0.05 was considered significant.Results: Three hundred and thirty nine patients were enrolled in this study.Out of 339 patients, 165 (48.7%) were male, and 51.3% (174) female.The majority of the patients were less than 30 years old (54.3%).Of all the patients, culture swabs were taken and only 56 (16.5%) were positive.Although the clinical dignosis did not show a significant relationship with the result of cultures (p>O.OS), the medicines prescribed by the physicians did (p<0.05).Most of the patients were diagnosed as having pharyingitis (22.7%), followed by acute bacterial rhinosinusitis (20.1 %) and tonsillitis (19.5%).The most frequently prescribed medicine was penicillin (39.1 Yo), followed by cephalosporins (28.8%) and macrolids (26.8%).Conclusions: In only 16.5% of the patients prescribed antibiotics, culture swabs were positive.This indicates that the physicians in the healrh centre of the university are prescribing antibiotics inconsistenrly.If antibiotic misuse continues, not only will the costs of care continue to increase but resistant bacterial infections will become increasingly common.This highlights the need for more prescriber education, especially as the range of medications available for general practitioner prescribing increases.Relevance to EGPRN: PHC plays an important role in the treatment of URTIs.Although there is no evidence to prescribe medicine for URTk, PHC physicians prescribe medicine for almost every patient.Since the spread of antibiotic-resistant bacteria is associated with antibiotic use, its being discussed in the European Forum would be profitable.
Language: English
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4243533908