General practitioners' perspectives on diagnosis and treatment of uncomplicated urinary tract infections: A qualitative study in the Northern Dutch-German cross-border region.

BACKGROUND

In the Netherlands and Germany, most antibiotics are prescribed in primary care, with urinary tract infections (UTIs) being the most common reason. The resistance rates of pathogens causing UTIs are rising in Europe. Differences in clinical practice guidelines may play a role and influence the prevalence of antibiotic resistance and treatment options. Therefore, we aim to explore the reality of general practices, including the diagnosis and management of uncomplicated UTIs in the Northern Dutch-German cross-border region.

METHODS

From January 2023 to April 2024, a qualitative study was performed using semi-structured interviews with German and Dutch general practitioners (GPs). The number of interviews was determined when data saturation was reached. The interviews were recorded, transcribed, translated and anonymised. MAXQDA (Version 24.1.0.) was utilised to code the interviews. The analysis was done using structured qualitative content analysis.

RESULTS

We recruited 13 GPs in Germany and 10 GPs in the Netherlands. Four main themes were identified: diagnosis, treatment options, decision making and guidelines. Dutch GPs delegated most diagnosis and treatment tasks to practice assistants, which is facilitated by the more stringent use of guidelines. More variety was seen in the types of antibiotics and herbal remedies used by German GPs.

CONCLUSIONS

This study provides valuable insights into GPs' decision making regarding the diagnosis and treatment of UTI. Increasing awareness of UTI diagnosis and treatment can help GPs assess their own practices and think more critically of their antibiotic use. Further research is needed to explore the effects on antibiotic resistance in the cross-border region.