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Effects of an optimised POCT guided diagnostic and treatment strategy for symptoms of uncomplicated UTI on use of appropriate antibiotics and uptake into primary care practice

Effects of an optimised POCT guided diagnostic and treatment strategy for symptoms of uncomplicated UTI on use of appropriate antibiotics and uptake into primary care practice
Effects of an optimised POCT guided diagnostic and treatment strategy for symptoms of uncomplicated UTI on use of appropriate antibiotics and uptake into primary care practice
Patients presenting with UTI symptoms are among the most frequent clinical presentations in primary care accounting for 15% of all community antibiotic prescriptions. The diagnostic accuracy of clinical assessment and the most appropriate management of uncomplicated UTI remain unclear. Primary care clinicians are more likely to treat empirically without additional testing. Some advances are being made in the development of novel Point of Care Tests (POCTs ) for diagnosis of infection and antibiotic resistance in primary care. The incorporation of a test, which enumerates and identifies pathogens and their antibiotic resistance, into a management strategy for UTI has great potential for improving patient outcomes reducing antibiotic use and in turn in reducing the incidence of antimicrobial resistance. While some new promising POCT technologies are being developed, these have not been fully evaluated in primary care. Robust evaluation, providing solid evidence supporting POCT use, which is based on patient benefit, cost-effectiveness, therapeutic choice, microbiological outcomes, and uptake and acceptance into primary care is required. We have designed a ?process-pathway' model which incorporates acceptability parameters for a POCT in primary care, and incorporates four distinct stages: Stage 1. Piloting of a novel POCT for diagnosis of UTI in primary care. Stage 2. An observational stage to describe current primary care management of uncomplicated UTI and incidence of uropathogens Stage 3. A randomised controlled trial rigorously evaluating the POCT as part of a rapid diagnostic and treatment regime for uncomplicated UTI. Stage 4. Evaluating the uptake of the POCT in general practice.
1745-6215
Bates, J.
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Thomas-Jones, E.
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Kirby, N.
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Pickles, T.
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Thomas, R.
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Bongard, E.
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Gal, M.
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Little, P.
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Verheij, T
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Llor, C.
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Cohen, D.
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Francis, N.
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Hood, K.
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Butler, C.
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Bates, J.
290a69e6-4f81-4dbe-b270-30e4155ca576
Thomas-Jones, E.
ea15d5ac-8232-4823-ab40-17bec0968520
Kirby, N.
062f0077-14a2-4270-88de-af9c436eb04c
Pickles, T.
e3fe9652-c8f4-4d1c-b07c-7acd132059c1
Thomas, R.
71afd8e4-51fd-49cd-96bf-76ac5552d864
Bongard, E.
498cda67-5b1a-4f3a-98f1-9c2b01c48410
Gal, M.
49434557-9212-4376-9f60-63b4df70dcb2
Little, P.
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Verheij, T
cc355b92-ba85-4102-98a0-cee55f0504f6
Llor, C.
ae93008f-896f-4983-88fc-0af9d012ac9d
Cohen, D.
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Francis, N.
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Hood, K.
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Butler, C.
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Bates, J., Thomas-Jones, E., Kirby, N., Pickles, T., Thomas, R., Bongard, E., Gal, M., Little, P., Verheij, T, Llor, C., Cohen, D., Francis, N., Hood, K. and Butler, C. (2013) Effects of an optimised POCT guided diagnostic and treatment strategy for symptoms of uncomplicated UTI on use of appropriate antibiotics and uptake into primary care practice. Trials, 14 (S1). (doi:10.1186/1745-6215-14-S1-P10).

Record type: Meeting abstract

Abstract

Patients presenting with UTI symptoms are among the most frequent clinical presentations in primary care accounting for 15% of all community antibiotic prescriptions. The diagnostic accuracy of clinical assessment and the most appropriate management of uncomplicated UTI remain unclear. Primary care clinicians are more likely to treat empirically without additional testing. Some advances are being made in the development of novel Point of Care Tests (POCTs ) for diagnosis of infection and antibiotic resistance in primary care. The incorporation of a test, which enumerates and identifies pathogens and their antibiotic resistance, into a management strategy for UTI has great potential for improving patient outcomes reducing antibiotic use and in turn in reducing the incidence of antimicrobial resistance. While some new promising POCT technologies are being developed, these have not been fully evaluated in primary care. Robust evaluation, providing solid evidence supporting POCT use, which is based on patient benefit, cost-effectiveness, therapeutic choice, microbiological outcomes, and uptake and acceptance into primary care is required. We have designed a ?process-pathway' model which incorporates acceptability parameters for a POCT in primary care, and incorporates four distinct stages: Stage 1. Piloting of a novel POCT for diagnosis of UTI in primary care. Stage 2. An observational stage to describe current primary care management of uncomplicated UTI and incidence of uropathogens Stage 3. A randomised controlled trial rigorously evaluating the POCT as part of a rapid diagnostic and treatment regime for uncomplicated UTI. Stage 4. Evaluating the uptake of the POCT in general practice.

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Published date: 29 November 2013

Identifiers

Local EPrints ID: 436304
URI: http://eprints.soton.ac.uk/id/eprint/436304
ISSN: 1745-6215
PURE UUID: ec1afa79-0608-41b2-a90b-7660448571c3
ORCID for N. Francis: ORCID iD orcid.org/0000-0001-8939-7312

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Date deposited: 06 Dec 2019 17:30
Last modified: 17 Mar 2024 03:58

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Contributors

Author: J. Bates
Author: E. Thomas-Jones
Author: N. Kirby
Author: T. Pickles
Author: R. Thomas
Author: E. Bongard
Author: M. Gal
Author: P. Little
Author: T Verheij
Author: C. Llor
Author: D. Cohen
Author: N. Francis ORCID iD
Author: K. Hood
Author: C. Butler

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