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    A survey of the management of urinary tract infection in children in primary care and comparison with the NICE guidelines.

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    Authors
    Kennedy, Kieran M
    Glynn, Liam G
    Dineen, Brendan
    Affiliation
    Department of General Practice, National University of Ireland, Galway, Ireland. kieran.m.kennedy@gmail.com
    Issue Date
    2010
    
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    Citation
    A survey of the management of urinary tract infection in children in primary care and comparison with the NICE guidelines. 2010, 11:6 BMC Fam Pract
    Journal
    BMC family practice
    URI
    http://hdl.handle.net/10147/93879
    DOI
    10.1186/1471-2296-11-6
    PubMed ID
    20102638
    Abstract
    BACKGROUND: The aim of this study was to establish current practices amongst general practitioners in the West of Ireland with regard to the investigation, diagnosis and management of urinary tract infection (UTI) in children and to evaluate these practices against recently published guidelines from the National Institute for Health and Clinical Excellence (NICE). METHODS: A postal survey was performed using a questionnaire that included short clinical scenarios. All general practices in a single health region were sent a questionnaire, cover letter and SAE. Systematic postal and telephone contact was made with non-responders. The data was analysed using SPSS version 15. RESULTS: Sixty-nine general practitioners were included in the study and 50 (72%) responded to the questionnaire. All respondents agreed that it is important to consider diagnosis of UTI in all children with unexplained fever. Doctors accurately identified relevant risk factors for UTI in the majority (87%) of cases. In collecting urine samples from a one year old child, 80% of respondents recommended the use of a urine collection bag and the remaining 20% recommended collection of a clean catch sample. Respondents differed greatly in their practice with regard to detailed investigation and specialist referral after a first episode of UTI. Co-amoxiclav was the most frequently used antibiotic for the treatment of cystitis, with most doctors prescribing a five day course. CONCLUSIONS: In general, this study reveals a high level of clinical knowledge amongst doctors treating children with UTI in primary care in the catchment area of County Mayo. However, it also demonstrates wide variation in practice with regard to detailed investigation and specialist referral. The common practice of prescribing long courses of antibiotics when treating lower urinary tract infection is at variance with NICE's recommendation of a three day course of antibiotics for cystitis in children over three months of age when there are no atypical features.
    Language
    en
    ISSN
    1471-2296
    ae974a485f413a2113503eed53cd6c53
    10.1186/1471-2296-11-6
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