MP23-09 PRACTICE PATTERNS ACROSS SPECIALTIES IN THE TREATMENT OF WOMEN WITH RECURRENT UTIS IN AN ACADEMIC HEALTHCARE SYSTEM

Abstract

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Kidney & Bladder II1 Apr 2017MP23-09 PRACTICE PATTERNS ACROSS SPECIALTIES IN THE TREATMENT OF WOMEN WITH RECURRENT UTIS IN AN ACADEMIC HEALTHCARE SYSTEM Matthew Sterling, Eliza Lamin, Alexander Skokan, Alan Wein, and Ariana Smith Matthew SterlingMatthew Sterling More articles by this author , Eliza LaminEliza Lamin More articles by this author , Alexander SkokanAlexander Skokan More articles by this author , Alan WeinAlan Wein More articles by this author , and Ariana SmithAriana Smith More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.737AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recurrent urinary tract infections (UTIs) are a common problem managed by a variety of medical specialties. Several treatment strategies exist and no evidence-based pathway of care has been established. The objective of this investigation is to better understand the practice patterns for managing patients with recurrent UTIs in a tertiary care healthcare system. METHODS A 17-question electronic survey regarding the management of recurrent UTIs in women was distributed to 210 providers in the Internal Medicine (IM), Family Medicine (FM), Ob-Gyn (OBG), and Urology departments. Recurrent UTIs was defined as =3 in 1 year. RESULTS A total of 68 (32.3%) providers completed the survey. Sixty percent (39/65) of providers report treating patients with recurrent UTIs with an extended course of antibiotics. Additionally, 35% (23/65) of providers treat despite lack of symptoms and 37% (24/65) of providers utilize suppressive antibiotics. OBG and Urologists utilize suppressive antibiotics more than IM and FM at 50%. Of those providing suppressive antibiotics, 79% (19/24) chose nitrofurantoin. Providers refer to specialists after trying a median of 3 courses of antibiotics (IQR 3-4). Referral to Urologists was most common for concomitant stones (88%, 51/58) or hydronephrosis (78%, 45/58), whereas referral to Infectious Disease (ID) was most common for bacterial resistance (75%, 51/68) or multiple patient allergies (48.5%, 33/68). Overall, 91.2% (62/68) of providers felt a protocol for evaluating and managing recurrent UTIs would be useful. CONCLUSIONS Practice patterns for managing recurrent UTIs in female patients vary across and within specialties within the same healthcare system. There is limited data to suggest extended courses of antibiotics are effective for recurrent UTIs and may potentially contribute to increasing susceptibility to infection, yet this strategy is commonly employed in our healthcare system. Although referral patterns differ between Urologists and ID specialists, multiple antibiotics are employed prior to referral. The majority of providers believe a written protocol would improve patient care, reducing variability and improving quality. © 2017FiguresReferencesRelatedDetailsCited bySmith A, Brown J, Wyman J, Berry A, Newman D and Stapleton A (2018) Treatment and Prevention of Recurrent Lower Urinary Tract Infections in Women: A Rapid Review with Practice RecommendationsJournal of Urology, VOL. 200, NO. 6, (1174-1191), Online publication date: 1-Dec-2018. Volume 197Issue 4SApril 2017Page: e296 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Matthew Sterling More articles by this author Eliza Lamin More articles by this author Alexander Skokan More articles by this author Alan Wein More articles by this author Ariana Smith More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...