You have accessJournal of UrologyPediatrics: Urinary Tract Infections/Vesicoureteral Reflux1 Apr 2015MP54-12 DETERMINANTS OF PRACTICE PATTERNS IN PEDIATRIC UTI MANAGEMENT Rachel Sharon Selekman and Hillary L Copp Rachel Sharon SelekmanRachel Sharon Selekman More articles by this author and Hillary L CoppHillary L Copp More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2035AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The purpose of this study was to investigate practice patterns of and factors that influence urine testing and antibiogram use in the setting of empiric antibiotic treatment of urinary tract infection (UTI) in children. METHODS We surveyed a random, cross-sectional, national sample of physicians caring for children from the American Medical Association Masterfile. Participants were queried regarding practice location and type, length of time in practice, factors influencing urine testing, urine specimen collection method, and antibiogram utilization. Logistic regression was used to assess factors associated with use of urine testing, bagged specimens, and antibiograms. RESULTS Of respondents who acknowledged contact by surveyors 44% completed the survey. Most respondents (84%) obtain urinalysis and culture prior to treatment for UTI. Neither physician age (p =0.56) nor practice type (p =0.16) are associated with always ordering urine testing, though emergency physicians, pediatricians, and urologists are more likely to order testing compared with all other specialists (family practitioners, internists, adolescent specialists, and nephrologists), p =0.03. Physicians who do not always obtain urine testing report they would more likely order testing if the specimen were easier to collect (46%) and if results were available immediately (48%) by point of care testing. Urine collection by bag was more commonly performed in circumcised boys (>30%) compared with about 20% of girls and uncircumcised boys (p =0.02). The most common reasons for collection by bag were parental refusal for (49%) and difficulty with (42%) catheterization. Neither physician age (p =0.63) nor practice type (p =0.27) are associated with increased use of a collection bag, though urologists are less likely to use a collection bag (p =0.05) compared with all other specialists. Of 70% of respondents reporting antibiogram access, <50% report that they use an antibiogram the majority of the time with empiric prescription. Physician age, practice type, and specialty were not associated with antiobiogram use (p >0.05). CONCLUSIONS While most practitioners follow guidelines to obtain urinalysis and culture prior to antibiotic prescription for UTI, urine collection by bag specimen is common, especially in circumcised males, and <50% of practitioners adhere to guideline recommendations for empiric antibiotic selection based on local antibiograms. Knowledge of these practice patterns can help direct interventions to improve adherence to UTI management guidelines. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e669 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rachel Sharon Selekman More articles by this author Hillary L Copp More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...