Perceptions and behaviours of infectious diseases physicians when managing urinary tract infections due to MDR organisms.

Abstract

OBJECTIVES:

The objective of this study was to attain a better understanding of infectious diseases (ID) physicians' experience with MDR organism (MDRO) urinary tract infections (UTIs) by means of a survey on disease perception, diagnostic management and treatment preferences.

METHODS:

A nine-question survey was developed and distributed to members of the North American Emerging Infections Network (EIN) in September 2013.

RESULTS:

Seven hundred and fourteen out of 1461 EIN members responded to the survey (49%). The responses of 603 responders were studied. Most providers perceived an increase in the incidence of MDRO UTIs over the past 3 years (75% of adult ID responders and 63% of paediatric ID responders). One hundred and thirty-four (22%) responders prefer intravenous over oral administration of antimicrobials when both are available, 171 (28%) prefer longer durations of therapy when comparing an MDRO with a susceptible isolate of the same species and 142 (24%) order a repeat urine culture as 'proof of cure' after treating an MDRO UTI. Nevertheless, 530 (88%) responders perceived MDRO UTIs to be of similar severity as non-MDRO UTIs. Fifty-five percent of providers prescribed fosfomycin for MDRO UTI at least once; the most common prescribing pattern (among a wide spectrum of approaches) was a single dose (16%).

CONCLUSIONS:

Future studies on MDRO UTIs should clarify the role of resistance in patient outcomes and the comparative efficacy of different antimicrobials. Of particular interest is fosfomycin, which is unrelated to other antibiotic classes and may take a more prominent role in treating MDRO cystitis.

• Authors: Sergio E Trevino, Hilary M Babcock, Jeffrey P Henderson, Michael A Lane, Susan E Beekmann, Philip M Polgreen, Jonas Marschall
• Journal: The Journal of antimicrobial chemotherapy (J Antimicrob Chemother) Vol. 70 Issue 12 Pg. 3397-400 (Dec 2015) ISSN: 1460-2091 [Electronic] England
• PMID: 26349519 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: © The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: [email protected].

Chemical References

• Anti-Bacterial Agents

Topics

• Anti-Bacterial Agents (therapeutic use)
• Attitude of Health Personnel
• Case Management
• Drug Resistance, Multiple, Bacterial
• Humans
• North America
• Physicians
• Surveys and Questionnaires
• Urinary Tract Infections (diagnosis, drug therapy)