• Eva M Aagaard, Paul Nadler, Joshua Adler, Judith Maselli, and Ralph Gonzales.
• Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA, USA. Eva.Aagaard@ucsf.edu
• J Gen Intern Med. 2006 Nov 1;21(11):1156-9.

ObjectiveTo validate and implement a computer module for the management of uncomplicated urinary tract infections (UTI).ParticipantsWomen age 18 to 64 years, with a previous UTI, voiding symptoms, and absence of complicating features (comorbidities, vaginal discharge, back pain, emesis, and fever/chills).MeasurementsThe computer module was validated against clinician diagnosis and urine culture. Following validation, the module was implemented in the urgent care clinic as a management option for women with suspected UTI; computer-directed therapy (CDT)-eligible women received antibiotic treatment without a clinician examination. Patient satisfaction with the module and return visits for UTI-related complaints were assessed.ResultsIn the validation study, 18 of 68 women (26%) were CDT-eligible. Clinicians diagnosed 17/18 CDT-eligible women with uncomplicated UTI. Sixty-seven percent of CDT-eligible women had a positive urine culture. Since implementation, 162 women have accessed the module, and 35% have received CDT. Ninety-eight percent (95% confidence interval: 95% to 100%) found the program easy to use and 95% (89% to 100%) would recommend it to friends/family. Two (4%) CDT-treated women had a return visit to our institution for a UTI-related illness within 2 weeks.ConclusionsA computer module accurately identifies women with culture-confirmed, uncomplicated UTIs. Patients are highly satisfied with the module.

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