GPs' treatment of uncomplicated urinary tract infections--a clinical judgement analysis in four European countries. DEP group. Drug Education Project

Abstract

Background: Non-adherence to recommendations for treatment of uncomplicated urinary tract infections (UTI) is common, but the reasons are not sufficiently understood.

Objectives: We aimed to assess and compare the influence of specific patient characteristics on GPs' treatment decisions for UTI in four European countries.

Methods: GPs in The Netherlands, Norway, Sweden and Germany were presented 18-26 case vignettes of UTI. Linear regression models were used to determine which patient characteristics predicted non-optimal decisions.

Results: Adherence to national recommendations varied both within and between countries, but there were remarkable similarities in the case characteristics predicting non-optimal decisions: a history of UTI and the patient's age were strongly related to prescription of second-choice antibiotics and longer treatment courses.

Conclusion: In all countries many GPs were reluctant to follow the recommendations in UTI cases that they might perceive as being more complicated.