Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Nov 19:2:26.
doi: 10.22454/PRiMER.2018.742456. eCollection 2018.

Knowledge and Practice Discordance in Treating Urinary Tract Infections

David W Bauer  1 , Julie Adkison  1 , Heather Hamilton  2
Affiliations

Knowledge and Practice Discordance in Treating Urinary Tract Infections

David W Bauer et al. PRiMER. .

Abstract

Background and objectives: Urinary tract infections (UTIs) are a common condition in women. Guidelines have been published on the diagnosis and management of such infections with the twin goals of improved patient safety and avoiding unnecessary health care costs. In this study we evaluated both physicians' knowledge of these guidelines, and whether that knowledge translates to their clinical practice.

Methods: We performed a retrospective chart review of UTI management before and after an educational intervention in a family medicine residency. Two control sites were also included. We also assessed physicians' knowledge of current UTI management guidelines using an anonymous quiz.

Results: At the intervention site, guideline adherence improved following the educational session. Inappropriate culture use decreased from 88% to 68% (P<.005) while first-line antibiotic use increased from 68% to 92% (P<.005). No such benefits were seen at the control sites. The control and intervention site providers did not differ in knowledge of antibiotic choice on the quiz (86% and 88% correct respectively, P=.85), but all control providers felt routine cultures were appropriate, whereas only 38% of the intervention providers did (P<.05).

Conclusions: A simple educational intervention made an impact on the management of UTI. Our results also highlighted that knowledge and practice are not always aligned.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Percent of Patients for Whom No Culture Was Ordered at the Control and Intervention Site, Before and After the Intervention
Figure 2
Figure 2
Percent of Patients Receiving Empiric First-Line Antibiotics at the Control and Intervention Site, Before and After the Intervention
Figure 3
Figure 3
Frequency of Antibiotic Choice at the Control and Intervention Site, Before and After the Intervention
See this image and copyright information in PMC

References

    1. Gupta K, Hooton TM, Naber KG, et al. Infectious Diseases Society of America; European Society for Microbiology and Infectious Diseases. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52(5):e103–e120. doi: 10.1093/cid/ciq257. - DOI - PubMed
    1. Warren JW, Abrutyn E, Hebel JR, Johnson JR, Schaeffer AJ, Stamm WE Infectious Diseases Society of America (IDSA) Guidelines for antimicrobial treatment of uncomplicated acute bacterial cystitis and acute pyelonephritis in women. Clin Infect Dis. 1999;29(4):745–758. doi: 10.1086/520427. - DOI - PubMed
    1. Michels TC, Sands JE. Dysuria: evaluation and differential diagnosis in adults. Am Fam Physician. 2015;92(9):778–786. - PubMed
    1. Fenwick EA, Briggs AH, Hawke CI. Management of urinary tract infection in general practice: a cost-effectiveness analysis. Br J Gen Pract. 2000;50(457):635–639. - PMC - PubMed
    1. Hooton TM. Practice guidelines for urinary tract infection in the era of managed care. Int J Antimicrob Agents. 1999;11(3–4):2 41–45. - PubMed