• P Villani, D Demet, P Ambrosi, R Brondino-Riquier, and G Bouvenot.
• Service de Médecine interne et Thérapeutique, Hôpital Sainte Marguerite, Marseille. pvillani@ap-hm.fr
• Presse Med. 2001 Sep 1; 30 (24 Pt 1): 1204-8.

ObjectiveThe aim of this prospective study was to observe diagnostic and antibiotic prescribing practices in urinary tract infection disease (UTID) in comparison with available guidelines.Patients And MethodsWe included all patients hospitalized in four medical wards of the Sainte-Marguerite Hospital in Marseille France who suffered from UTID.ResultsDuring the study period, 60 cases of UTID were observed, 29 were community-acquired and 31 were nosocomially-acquired. Management of uncomplicated UTID, the most frequent type (47/60 cases), showed considerable divergence between practices and guidelines. Not in keeping with the guidelines, urinalysis reagent strips were only used for 3 of the 47 cases. Furthermore, broad-spectrum antibiotics were prescribed as the first line treatment in more than 70% of the patients whereas only half of these prescriptions were warranted according to the guidelines. For complicated UTID however (13 cases) diagnostic and antibiotic prescribing practices were globally in accordance with the guidelines.ConclusionThis survey points out the divergence between guidelines and real management of UTID in hospitals. Clinical practices should be revisited to be in agreement with guidelines. Drafting antibiotic prescription guides explaining UTID management would be helpful for training future physicians.

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