Approach of Physicians Working in Primary Healthcare Service to Asymptomatic Bacteriuria and Urinary Tract Infections

• Published in: Medical journal of Bakirköy Vol. 18; no. 3; pp. 266 - 272
• Main Authors: Polat, Hakan, Polat, Özlem, Karadağ, Serdar, Evren, İsmail, Kargı, Taner, Taşçı, Ali İhsan
• Format: Journal Article
• Language: English
• Published: Galenos Yayınevi 27.09.2022
• Subjects: Tıp; İstanbul; Türkiye; Asymptomatic bacteriuria; idrar yolu enfeksiyonu; birinci basamak sağlık hizmetleri; primary healthcare service; urinary tract infection; Asemptomatik bakteriüri
• ISSN: 1305-9319; 1305-9327
• DOI: 10.4274/BMJ.galenos.2022.2022.4-18

Objective: Asymptomatic bacteriuria (ASB) is often misdiagnosed as urinary tract infection. However, it does not require treatment. Although the guidelines recommend against the treatment of ASB with antibiotics, it has been reported that unnecessary antibiotic use is common, especially in outpatient centers. We evaluated the ASB approach in primary care physicians using an internet-based questionnaire. Methods: In this study conducted between May-August 2021, family physicians working in family health centers in Istanbul and healthcare professionals work as family medicine specialists and residents in training-research hospitals were included. A form that was created to evaluate the descriptive features, urinalysis-urine culture conditions, and the treatments administered was used as a data collection tool. Results: In this study, 436 family physicians were included. The findings showed that 91.3% (n=398) of the physicians gave treatment to patients who had positive urinalysis or urine culture and had no urinary symptoms. The rate of use of unnecessary treatment by physicians working in family health centers was significantly higher than that in hospitals. We observed that the most frequently used agent in the treatment is fosfomycin. Conclusion: Most cases of overtreatment of ASB are based on the laboratory results rather than the clinical condition of the patients. The available evidence suggests that a combination of educational and organizational interventions would help improve the distinction between symptomatic urinary infection and ASB and adherence to evidence-based guidelines, and that ASB should be in a priority group for antimicrobial management programs.