ST-LÄKARES HANDLÄGGNING AV UVI IPRIMÄRVÅRDEN

Background Urinary tract infection (UTI) is a common diagnose in primary care and one of the mainreasons for prescription of antibiotics. Resistance to antibiotics is a major global issue andcareful use of antibiotics is needed to slow the development of antibiotic resistance. Aim The aim of this study was to investigate the level of adherence of resident physicians inÖrebro County to Swedish national guidelines concerning diagnostics and treatment of UTI inthe primary care setting. Method An online survey was sent to physicians in general practice in Örebro County. The surveycontained five hypothetical cases portraying patients with potential UTI, which each haddifferent underlying co-morbidities. The participants answered questions regardingdiagnostics and treatment for each patient. The results were analyzed and compared to currentnational Swedish guidelines. Results With the five cases and 28 participants there were 140 answers regarding the use of urineculture, of which 122 were in line with national guidelines. In one case portraying a womanwith possible presence of resistant pathogens only 17 of 28 participants followed theguidelines, recommending culture. Regarding treatment of UTI the participants answeredaccording to the guidelines in 122 of 140 answers and regarding admitting the patient toinpatient care the guidelines were followed in 116 of 140 situations. In the case of a womanwith possible pyelonephritis, however, only 10 of 28 participants seemed to be aware of theunderlying risk of sepsis and referred the patient. Conclusion The adherence to national guidelines was rather good, with exception of the case presenting awoman with pyelonephritis and signs of sepsis, where only 10 of 28 followed the guidelinesregarding referring her for inpatient care. Although a good overall performance there seems tobe some room for improvement regarding the adherence to guidelines for the diagnostics andtreatment of UTI