Évaluation des pratiques professionnelles sur la prise en charge des infections urinaires basses de l'adulte en médecine générale en Normandie (Calvados, Manche, Orne) avec la collaboration des groupes qualité et de normantibio

Abstract : Objective: in a setting of emerging antibiotic resistances, our objective was to measure the quality of clinical practice for the management of cystitis in adults in general practice in Normandy (states 14, 50, 61) by collaborating with quality circles and the regional center for antibiotic counsel. Methods: we performed a cross-sectional study of clinical practice in 2018 in Normandy with general practitioners participating in quality circles and a sample outside quality circles, by using a questionnaire composed of clinical vignettes. We studied simple, at risk of complication, recurrent and caused by multi-drugresistant bacteria cystitis, as referenced in the 2017 guidelines of the French Infectious Disease Society. Results: 142 general practitioners participated in this study. For each cystitis studied, the mean percentage of compliant responses was: 85.2% simple cystitis, 39.2% at risk of complication, 60.0% recurrent, 13.7% caused by multi-drug-resistant bacteria. For the type of criteria evaluated, it was: 26.4% diagnostic criteria, 76.5% diagnostic means and 44.3% treatments. Two criteria studied had less than 10% of compliant answers: knowledge of complication risk factors for cystitis (8.5%) and positivity thresholds of urine cultures (9.9%). Conclusion: the adherence of general practitioners to the current guidelines for cystitis in adult women could be improved. It is necessary to improve the knowledge on antibiotics prioritization, cystitis definitions and the management of cystitis caused by multi-drug-resistant bacteria.
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Master Thesis
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Claire Beaurain. Évaluation des pratiques professionnelles sur la prise en charge des infections urinaires basses de l'adulte en médecine générale en Normandie (Calvados, Manche, Orne) avec la collaboration des groupes qualité et de normantibio. Médecine humaine et pathologie. 2018. ⟨dumas-02050493⟩

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