André Malin, Mölstad Sigvard, Lundborg Cecilia Stålsby, Odenholt Inga
Centre for Clinical Research, Dalarna and Primary Care, Division of Medicine and Care, Faculty of Health Sciences, Linköping, Sweden.
Scand J Infect Dis. 2004;36(2):134-8. doi: 10.1080/00365540410019075.
A diagnosis-antibiotic prescribing study was performed in 5 counties in Sweden during 1 week in November in the y 2000 and 2002, respectively. As part of the study, the characteristics and clinical management of patients who received diagnoses of urinary tract infections (UTIs) (n = 1564) in primary care, were analysed. 85% of the visits were by women, and 74% of all consultations were diagnosed as lower UTIs. One or more diagnostic tests were performed in 98% of the women with suspected lower or recurrent UTIs and 95% were prescribed an antibiotic. The most commonly prescribed antibiotics for lower UTIs were trimethoprim followed by pivmecillinam and a quinolone. The study indicated a change in antibiotic prescribing with improved adherence to the national recommendations. There was an increase of prescribed nitrofurantoin and a decrease of prescribed quinolones to women with lower UTIs between the studied y. Furthermore, 3-d treatment with trimethoprim increased although the prescribed duration was mostly 7 d. In contrast to the guidelines, few urine cultures were performed. The study highlights the necessity of updating the guidelines for the management of lower UTIs in general practice.
2000年和2002年11月的某一周，在瑞典的5个县开展了一项诊断-抗生素处方研究。作为该研究的一部分，对在初级保健中被诊断为尿路感染（UTIs）（n = 1564）的患者的特征和临床管理情况进行了分析。85%的就诊患者为女性，所有会诊中有74%被诊断为下尿路感染。在疑似下尿路感染或复发性尿路感染的女性患者中，98%进行了一项或多项诊断检测，95%的患者被开具了抗生素。下尿路感染最常开具的抗生素是甲氧苄啶，其次是匹美西林和喹诺酮类。该研究表明抗生素处方发生了变化，对国家推荐的遵循情况有所改善。在所研究的年份之间，下尿路感染女性患者中开具的呋喃妥因有所增加，喹诺酮类有所减少。此外，虽然规定疗程大多为7天，但甲氧苄啶的3天疗程有所增加。与指南相反，进行尿液培养的情况很少。该研究强调了更新基层医疗中下尿路感染管理指南的必要性。
