Incidence, Diagnosis and Treatment of Urinary Tract Infections in Family Medicine Offi ces

Na uzorku od 7.679 bolesnika (četiri tima obiteljske medicine) u 4 mjeseca istraživanja izmjerena je incidencija mokraćnih infekcija veća od 5%. Bolest je učestalija kod mlađih muškaraca i starijih žena. Bez urinokulture postavljeno je 44% dijagnoza, a između timova postoje znatne razlike u vrstama propisanih antibiotika. Potrebno je ujednačiti i na razini zdravstvenog sustava prihvatiti dijagnostičke i terapijske smjernice za mokraćne infekcije. Potrebno znanje u propisivanju antibiotika kod mokraćnih infekcija treba omogućiti proaktivnom i interaktivnom te mjerljivom primjenom (on-line) smjernica na aplikativnim rješenjima u ordinacijama obiteljske medicine. Treba i liječnicima i osiguranicima osigurati udobniju i bržu dostupnost na pretrage urina i urinokulturu kod sumnje na mokraćnu infekciju. Ovako nastali trošak višestruko će se vratiti smanjenim brojem komplikacija i racionalnijim propisivanjm antibiotika. Urinokultura s antibiogramom treba biti pretraga poticana od strane HZZO-a, a ne smatrana nepotrebnim troškom.Four family medicine offi ces found an incidence of urinary infections greater than 5% in a sample of 7679 patients in a four-month research period. The disease is more prevalent among younger males and older females. As regards diagnoses, 44% were established without urine culture; signifi cant differences were also found in antibiotic prescribed for treatment of urinary infections. Diagnostic and therapeutic guidelines should be standardized and adopted on the healthcare system level. They should be used proactively and interactively through software applications in family medicine offi ces. In any suspected urinary infection, urine tests and urine cultures should be made more accessible both to doctors and patients. The benefi ts of this investment would be multiple – reduced complications and more rational prescription of antibiotics. In fact, the Croatian Institute for Health Insurance should stimulate laboratory tests including the antibiotic sensitivity test, instead of treating it as an unnecessary cost