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Master Thesis

Facteurs influençant l’antibiothérapie probabiliste en cas de suspicion d’infection urinaire basse chez la femme en soins primaires

Abstract : Objectives: The urinary tract infection (UTI) is the 2nd motive for prescription of antibiotics in primary care. There are clinical scores and the use of the urinary dispticks is recommended to limit the prescription. The objective of our study was to determine factor influencing the general practitioner (GP) in its prescription of empiric antibiotic therapy in case of suspicion of low urinary tract infection to woman. Methods: From AquiBMR, prospective study led from February till July, 2014 with 38 GP, we realized a study concerning the suspicions of low UTI at the woman. We made a multivariated analysis with the software R on the different factors influencing the prescription of antibiotic after adjustment on the possible confounders. Results: Among 306 women suspected to present an UTI, 238 (77,8%) received an antibiotic. The clinical signs associated to this prescription were burning sensations (OR 3.89, p 0.00002) and urgency (OR 2.66, p 0.01). The signs associated negatively were the age upper to 75 years (OR 0.3, p 0.02) a vaginal discharge (OR 0.29, p 0.05) or others symptoms (0.2, p 0.03). An urinary disptick was ealized at 237 women (77,4 %). 84,1% of prescription if positive and 44,8 % if negative. The fact of realizing a urinary dipstick was not significantly associated with a lesser prescription (OR 1.66, p 0.18) after adjustment on the clinical signs. Conclusions: The GP prescribes a treatment antibiotic more easily as the patient is young and present typical and noisy symptoms. The realization of an urinary disptick is not a significant protective factor of the prescription in multivariated analysis.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01200480
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Submitted on : Tuesday, October 6, 2015 - 2:59:02 PM
Last modification on : Sunday, October 25, 2020 - 7:04:53 AM
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Daphné Rouveyrol. Facteurs influençant l’antibiothérapie probabiliste en cas de suspicion d’infection urinaire basse chez la femme en soins primaires. Médecine humaine et pathologie. 2015. ⟨dumas-01200480⟩

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