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Master Thesis

Prise en charge par les médecins généralistes béarnais des infections urinaires communautaires à Entérobactéries sécrétrices de bêta-lactamases à spectre étendu

Abstract : Introduction: in urinary tract infections (UTI), the spread of extended-spectrum beta-lactamase-producing enterobacteriaceae (ESBLE) worries. For the first time, recommendations include the possibility of a multidrug-resistant bacteria in the choice of first-line antibiotics. Objective: evaluate general practionners’ practices (GP) in cases of UTI caused by ESBLE, their interest and expectations on this matter. Method: study conducted during summer 2017 on 200 GP in Bearn, towards a questionnaire with a clinical test. Four clinical situations were approached : simple acute cystitis, colonization and cystitis at risk of complications, simple pyelonephritis and male UTI. The principal judgement’s criteria, called total concordance, contained the prescription of a first-line antibiotic, in correct dosage, and during the good period, without doing any control of urine culture, according to the last 2014 recommendations. Results: 109 GP replies, among which 77% knew the term “ESBLE”. GP who had taken a UTI caused by ESBLE before felt significantly more concerned by their spread. 17,4% of GP filled in the definition of total concordance, 38% chose a first-line antibiotic, 93% of dosages and 57,1% of periods were correct. 51,4% of GP asked for a control of urine culture. Most of GP thought useful the creation of helping documents for the prescription in UTI caused by ESBLE Conclusion: GP are the front line against the explosive spread of antimicrobial resistance. Their awareness and formation level must be raised to optimize the management of infections and fight the misuse.
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Master Thesis
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Lucie Ferraton. Prise en charge par les médecins généralistes béarnais des infections urinaires communautaires à Entérobactéries sécrétrices de bêta-lactamases à spectre étendu. Médecine humaine et pathologie. 2017. ⟨dumas-01676324⟩

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