'Male cystitis does not exist': A qualitative study of general practitioners' experiences and management of male urinary tract infections in France.
Humans
Male
Urinary Tract Infections
/ drug therapy
France
General Practitioners
Cystitis
/ drug therapy
Practice Patterns, Physicians'
Anti-Bacterial Agents
/ therapeutic use
Qualitative Research
Fluoroquinolones
/ therapeutic use
Middle Aged
Adult
Female
Antimicrobial Stewardship
Primary Health Care
Qualitative research
anti-bacterial agents
primary care
prostatitis
urinary tract infections
Journal
The European journal of general practice
ISSN: 1751-1402
Titre abrégé: Eur J Gen Pract
Pays: England
ID NLM: 9513566
Informations de publication
Date de publication:
Dec 2024
Dec 2024
Historique:
medline:
17
6
2024
pubmed:
17
6
2024
entrez:
17
6
2024
Statut:
ppublish
Résumé
Male urinary tract infections (mUTIs) are rare in primary care. The definition of mUTIs varies across countries. The therapeutic management of mUTIs in France is based on a 14-day course of fluoroquinolones despite a high risk of antimicrobial resistance. The objective of this qualitative study was to explore general practitioners' (GPs) experiences and behaviours regarding the diagnostic and therapeutic management of mUTIs. GPs were recruited by convenience sampling in Haute Normandie (France) and interviewed individually with semi-structured guides. GPs' experiences and behaviours were recorded and analysed using an interpretive phenomenological approach. From March 2021 to May 2022, 20 GPs were included in the study. Defining a mUTI was perceived as a diagnostic challenge. A diagnosis based on clinical evidence alone was insufficient and complementary tests were required. For GPs: 'male cystitis does not exist'. A mUTI was considered an unusual disease that could reveal an underlying condition. GPs considered fluoroquinolones to be 'potent' antibiotics and treated all patients with the same 14-day course. GPs implemented improvement strategies for antibiotic stewardship and followed the guidelines using a computerised decision support system. GPs' experiences of mUTIs are limited due to low exposure and variable clinical presentations in primary care, representing a diagnostic and therapeutic challenge. In order to modify GPs' antibiotic prescribing behaviours, a paradigm shift in the guidelines will need to be proposed.KEY MESSAGESDefining a male urinary tract infection represents a diagnostic challenge for GPs.A diagnosis based on clinical evidence alone is insufficient and complementary tests are required.A male urinary tract infection is an unusual disease in primary care and suggests a more serious underlying condition.
Sections du résumé
BACKGROUND
UNASSIGNED
Male urinary tract infections (mUTIs) are rare in primary care. The definition of mUTIs varies across countries. The therapeutic management of mUTIs in France is based on a 14-day course of fluoroquinolones despite a high risk of antimicrobial resistance.
OBJECTIVES
UNASSIGNED
The objective of this qualitative study was to explore general practitioners' (GPs) experiences and behaviours regarding the diagnostic and therapeutic management of mUTIs.
METHODS
UNASSIGNED
GPs were recruited by convenience sampling in Haute Normandie (France) and interviewed individually with semi-structured guides. GPs' experiences and behaviours were recorded and analysed using an interpretive phenomenological approach.
RESULTS
UNASSIGNED
From March 2021 to May 2022, 20 GPs were included in the study. Defining a mUTI was perceived as a diagnostic challenge. A diagnosis based on clinical evidence alone was insufficient and complementary tests were required. For GPs: 'male cystitis does not exist'. A mUTI was considered an unusual disease that could reveal an underlying condition. GPs considered fluoroquinolones to be 'potent' antibiotics and treated all patients with the same 14-day course. GPs implemented improvement strategies for antibiotic stewardship and followed the guidelines using a computerised decision support system.
CONCLUSIONS
UNASSIGNED
GPs' experiences of mUTIs are limited due to low exposure and variable clinical presentations in primary care, representing a diagnostic and therapeutic challenge. In order to modify GPs' antibiotic prescribing behaviours, a paradigm shift in the guidelines will need to be proposed.KEY MESSAGESDefining a male urinary tract infection represents a diagnostic challenge for GPs.A diagnosis based on clinical evidence alone is insufficient and complementary tests are required.A male urinary tract infection is an unusual disease in primary care and suggests a more serious underlying condition.
Identifiants
pubmed: 38881418
doi: 10.1080/13814788.2024.2362693
doi:
Substances chimiques
Anti-Bacterial Agents
0
Fluoroquinolones
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM