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Master Thesis

Étude de la sensibilité des bactéries aux antibiotiques prescrits en première intention par les médecins généralistes dans les infections urinaires communautaires

Abstract : Introduction: General practitioners (GPs) are confronted with increasing rates of antibiotic-resistance in bacteria causing urinary tract infections (UTIs) to antibiotics most commonly prescribed in UTI treatment. As a result, GPs must adapt their prescribed treatments in response to the changing bacterial ecology. Objective: To evaluate whether antibiotics prescribed by GPs for the empirical treatment of UTIs showed a rate of bacterial resistance of less than 20% in uncomplicated cystitis and less than 10% in complicated cystitis, pyelonephritis, and men urinary tract infections. Patient and methods: Prospective, multicenter study of ambulatory medicine in the Aquitain region of France. This study included 392 patients with suspected UTIs, seen by 38 participating GPs between January and July 2014. Following the initial consultation, a urine culture was ordered for each patient, regardless of the chosen treatment strategy. A clinical and epidemiological survey specified the empirical course of antibiotic therapy. Results: In the uncomplicated cysticis, the majority of antibiotics showed a resistance rate of less than 20%. Fosfomycin was prescribed in first intention (61.7% of prescriptions, resistance rate 10.5%). Fluoroquinolones were most commonly prescribed as an empiric first-choice antibiotic for complicated cystitis (46.5%, resistance 10.9%), pyelonephritis (73.7%, resistance 5.3%), and UTIs in male patients (69.4%, resistance 12.5%). In complicated cystitis and male UTIs, the resistance rate was frequently more than 10%. Conclusions: Due to the bacterial resistance of pathogens found in complicated cystitis and male IUTs, it is necessary to wait for the results of the urine culture before treating patients. For this reason, it is important to postpone the beginning of antibiotic treatment whenever is possible.
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Master Thesis
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Submitted on : Thursday, March 24, 2016 - 4:18:16 PM
Last modification on : Wednesday, August 23, 2017 - 4:33:19 PM
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Christelle Alphand. Étude de la sensibilité des bactéries aux antibiotiques prescrits en première intention par les médecins généralistes dans les infections urinaires communautaires. Médecine humaine et pathologie. 2016. ⟨dumas-01293414⟩

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