Knowledge, attitudes and practices around urinary tract infections of general practitioners in the Netherlands: a cross-sectional internet survey

Abstract

OBJECTIVES: Urinary tract infections (UTIs) are the most common reason for women to consult a general practitioner (GP). Current diagnostic tests are inadequate, complicating diagnosis and treatment decisions for GPs. To understand how this influences GPs in managing UTI, we aimed to determine GPs' knowledge, attitudes, and practices around UTI care. DESIGN: Cross-sectional internet-based survey. SETTING: General practice in the Netherlands between December 2021 and February 2022. PARTICIPANTS: We distributed invitations to participate via email to 126 practices. Additionally, we distributed invitations via social media and newsletters. OUTCOMES: The survey included 15 questions covering GPs' sociodemographic information, knowledge, attitudes and practices. Data analysis was based on frequencies and descriptive statistics. RESULTS: Among the 190 eligible respondents, 172 (90.5%) chose dysuria and 140 (73.7%) chose urinary frequency as a symptom likely indicating UTI in healthy women. One in three GPs would diagnose a UTI based on non-specific complaints with positive leucocyte and erythrocyte tests, discordant with established guidelines. GPs indicated that better point-of-care diagnostics would help improve antibiotic prescribing (72.6%) and would conserve time (60.0%). GPs considered a positive test result the most important factor to prescribe antibiotics while patient expectation was considered least important. Half of GPs indicated that the most urgent need in UTI care is improved diagnostics. CONCLUSION: GPs often act in discordance with established guidelines, rely on non-specific symptoms for the diagnosis of UTI and rank patient expectation as less important in comparison to symptom recognition and culture result when deciding on antibiotic treatment.