Artikel
Treating uncomplicated urinary tract infections in the Netherlands and Germany in primary care: a comparison of clinical practice guidelines
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Autoren
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Aida Bedri
- Universität Oldenburg, Department für Versorgungsforschung, Abteilung Allgemeinmedizin, Oldenburg, Deutschland
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Imke Aits
- Universität Oldenburg, Department für Versorgungsforschung, Abteilung Allgemeinmedizin, Oldenburg, Deutschland
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Marco Blanker
- University Medical Center Groningen, Department of General Practice and Elderly Care Medicine, Groningen, Niederlande
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Axel Hamprecht
- Universität Oldenburg, Klinikum Oldenburg, Universitätsinstitut für medizinische Mikrobiologie und Virologie, Oldenburg, Deutschland
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Henk van der Worp
- University Medical Center Groningen, Department of General Practice and Elderly Care Medicine, Groningen, Niederlande
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Matthijs Berends
- Certe Medische Diagnostiek en Advies [Certe Medical Diagnosis and Advice], Niederlande; University Medical Center Groningen, Department of Medical Microbiology and Infection Prevention, Groningen, Niederlande
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Alexander Winter
- Universität Oldenburg, Klinikum Oldenburg, Universitätsklinik für Urologie, Oldenburg, Deutschland
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Bianca Michalik
- Universität Oldenburg, Klinikum Oldenburg, Universitätsklinik für Urologie, Oldenburg, Deutschland
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Corinna Glasner
- University Medical Center Groningen, Department of Medical Microbiology and Infection Prevention, Groningen, Niederlande
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Michael Freitag
- Universität Oldenburg, Department für Versorgungsforschung, Abteilung Allgemeinmedizin, Oldenburg, Deutschland
| Veröffentlicht: | 15. September 2022 |
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Gliederung
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Hintergrund: Analysing differences in prescription and consumption of antibiotics between countries can contribute towards understanding the underlying reasons for antibiotic treatment decisions. In the Netherlands and Germany, most antibiotics are prescribed in primary care. Differences in clinical practice guidelines may play an important role and influence the prevalence of antibiotic resistance and treatment options.
Fragestellung: To what extent are there differences in the urinary tract infection (UTI) guidelines in primary health care in the Netherlands and Germany?
Methoden: This literature review assesses the similarities and differences in the current national UTI guidelines for general practitioners in the Netherlands and Germany for otherwise healthy non-pregnant women with uncomplicated UTI and, in particular, uncomplicated cystitis. The guideline recommendations for children and youth were excluded when possible.
Ergebnisse: Differences were found concerning the recommended diagnostic procedures. In the Netherlands, it is recommended to perform diagnostics with the help of dipsticks and not to treat patients only on the basis of complaints. Conversely, the German guideline only recommends a dipstick in uncertain cases of UTI and the treatment can be started based on anamnesis if there are no indications of complications.
In the Netherlands, the first antibiotic of choice is nitrofurantoin followed by fosfomycin and trimethoprim. The antibiotics of choice in Germany are fosfomycin, nitrofurantoin, nitroxoline and pivmecillinam. In both countries, participatory decision-making is recommended regarding treatment without antibiotics for mild-to-moderate courses of UTI.
Diskussion: The relevance of guideline differences in diagnosing and treating UTI for clinical practice and antimicrobial resistance will be discussed. This will contribute to improving guideline acceptance and adherence in practice. Further research on how the guidelines are implemented is planned to explore the management of UTIs in both countries and to compare and improve clinical practice.
Take Home Message für die Praxis: The practice routines should be reflected and take guideline recommendations into account.
