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Abstract Background: Doctors working in emergency departments on the primary care level often face patients with signs of uncomplicated lower urinary tract infections. The aim of this study was to determine the adherence to guidelines in the management of such patients in emergency units. Methods: This was a prospective study that took place from February 1st to July 30th 2011. The emergency departments of all primary health centres in Slovenia (N = 60) were invited. Invitation was accepted by 14 (23.3%) of them. In the sample, 10 consecutive women (including home visits and telephone consultations) in every emergency department were included. A total of 139 patients (23.2%) participated in the study. We collected data with a questionnaire, which was filled in by the doctor on duty for each patient individually. Results: The final sample included 117 women (84.2%), aged 20-64 years. Physicians in the emergency department prescribed therapy according to the guidelines for the treatment of an uncomplicated urinary tract infection in one quarter of the patients. The first choice antibiotic was prescribed to most patients, however the duration of treatment exceeded the recommendation. No clear pattern of factors that influenced physicians’ decision to treat patients according to the guidelines was detected. Although the age of the patient and some anamnestic data may have some influence. Conclusions: This study provides the first insight into the management and treatment of women with uncomplicated urinary tract infection in primary care emergency departments in Slovenia. Physicians in primary care emergency departments need additional knowledge and measures to better adhere to the guidelines for the treatment of uncomplicated urinary tract infection in women Izvleček Izhodišča: Zdravniki, ki delajo v dežurnih ambulantah, se pogosto srečujejo z bolnicami z znaki nezapletene okužbe spodnjih sečil. Cilj raziskave je bil ugotoviti upoštevanje smernic pri obravnavi takšnih bolnic v dežurnih ambulantah. Metode: Raziskava je bila prospektivna in je potekala od 1. 2. do 31. 7. 2011. K sodelovanju smo povabili dežurne ambulante vseh zdravstvenih domov v Sloveniji (N = 60), sodelovalo pa jih je 14 (23,3 %). Vzorec je zajemal deset zaporednih obiskov bolnic z akutno nezapleteno okužbo sečil (vključno s hišnimi obiski in posveti po telefonu) v vsaki posamezni dežurni ambulanti in je predstavljal 139 bolnic (23,2 %). Zdravniki so izpolnili priložnostni obrazec za vsako posamezno bolnico. Rezultati: V končni vzorec je bilo vključenih 117 bolnic (84,2 %), starih 20-64 let. Pri zdravljenju bolnic z nezapleteno okužbo spodnjih sečil so zdravniki v dežurnih ambulantah v celoti sledili smernicam za zdravljenje pri četrtini bolnic. Bolnicam so sicer v večini predpisali pravilen antibiotik prve izbire, vendar pa dolžina medikamentoznega zdravljenja v večini ni bila skladna s smernicami. Jasnega vzorca vplivov na zdravnikovo odločitev, da zdravi takšne bolnice skladno s smernicami, nismo uspeli dokazati. Manjši vpliv na razlike so imeli le starost bolnice in nekateri podatki iz anamneze. Zaključki: To je prva raziskava, ki proučuje obravnavo bolnic z nezapleteno okužbo sečil v dežurni ambulanti v osnovnem zdravstvu v Sloveniji. Zdravniki, ki delajo v dežurnih ambulantah na primarni ravni, potrebujejo ukrepe za izboljšanje upoštevanja smernic pri obravnavi bolnic z nezapleteno okužbo spodnjih sečil.

zdravstveno varstvo/slovenian journal of public health

Upoštevanje Smernic Za Zdravljenje Nezapletene Okužbe Spodnjih Sečil V Dežurni Ambulanti Osnovnega Zdravstva / Adherence to Guidelines for the Treatment of Uncomplicated Lower Urinary Tract Infections in the Primary Care Emergency Department