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research-project
Research project

Reducing antibiotics for treating urinary tract infections

Status: Ongoing (September 2020 - September 2022)

A project aimed at reducing antibiotic prescriptions for uncomplicated urinary tract infections in general practice, by promoting a wait and see approach for the first week of symptoms.

What we do

About our project

Background
Urinary tract infections (UTI) are a mostly harmless, often self-limiting condition for healthy women. Incidence is high with 124 cases per 1000 women per year. GPs prescribe antibiotics in 75% of the cases, while we know from literature that over 50% of women will be free of symptoms after one week, without treatment. With this project we will try to promote the wait-and-see approach for women with uncomplicated UTIs, by installing a new protocol, train the practice assistants and inform patients about the possibility of the wait and see approach.

Hypothesis
We hypothesize that a de-implantation strategy aimed at practice assistants and patients, will reduce the amount of antibiotics prescribed for uncomplicated urinary tract infections, and, when an antiobiotic is given, will increase the amount of days between diagnosis and antibiotic prescription.

Methods
In five participating general practices, we will work together with a doctor and practice assistant to renew the protocol for women with a UTI. We will provide a training for the practice assistants about the natural course of a UTI and about shared decision making. For patients we will provide information regarding the different treatment options. Aim of the new protocol is to advise healthy women aged 18 years and older with a UTI to wait and see for the first 7 days of the complaints. The effect of the de-implementation strategy will be evaluated using the Rijnmond Gezond database. We will compare the amount of antibiotics prescribed for UTIs and the number of days between diagnosis and prescription during the post-intervention year, compared to the five preceding years.

Our research focus

Primary outcome
The primary outcome is percentage of patients with a prescription for an antibiotic on the day of the diagnosis with a UTI.

Secondary outcome

Secondary outcome is the number of days between diagnosis and prescription of antibiotics. We will also measure days of complaints before consulting the GP and possible complications.

Funds & Grants

Citrien Fonds: To do or not to do program.

Our team

Dr. R.M. Rozendaal, r.rozendaal@erasmusmc.nl
V. Voorbrood, v.voorbrood@erasmusmc.nl
Dr. E.I.T. de Schepper, e.deschepper@erasmusmc.nl

Contact address for the project: r.rozendaal@erasmusmc.nl.