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Family Practice Vol. 16, No. 6, 605-607
© Oxford University Press 1999

GPs' treatment of uncomplicated urinary tract infections—a clinical judgement analysis in four European countries

Eva Hummers-Pradier, Petra Deniga, Thimothy Okeb, Per Lagerløvc, Rolf Wahlströmd, Flora M Haaijer-Ruskampa and the Dep Group

Department of General Practice, University of Göttingen, Humboldtallee 38, D-37073 Göttingen, Germany,
a Northern Centre for Healthcare Research, University of Groningen, The Netherlands,
b National Board of Health and Welfare, Stockholm, Sweden,
c Department of Pharmacotherapeutics, University of Oslo, Norway and
d IHCAR, Karolinska Institutet, Stockholm, Sweden.

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.

Keywords. Antibiotics, decision-making, drug utilization, family practice, urinary tract infections..


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