Management of uncomplicated paediatric urinary tract infections among General Practitioners in West Ireland
Fahisham TAIB, Wan Nor Maniza WAN HASAN, Bakht JAMAL
1 School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia, and 2 Portiuncula Hospital, Ballinasloe, County Galway, Ireland
ABSTRACT
Introduction: Urinary tract infection (UTI) is a common infection in children. The management of UTI is usually straight forward, but in the community setting, the general practitioners (GPs) face difficult decision once UTI is suspected. The aim of this study was to examine the management of paediatric UTI among the GPs working in West Ireland. Materials and Methods: A postal questionnaire based on a case scenario of simple or uncomplicated paediatric UTI was sent to the 198 GPs in the rural regions in the West of Ireland who commonly refer cases to the Portiuncula Hospital, Ballinasloe. The questionnaire consisted of a standardised set of questions covering diagnosis, urine processing, result interpretation, treatment instituted, hospital referral and advice on UTI’s management. A letter explaining the purpose of the questionnaire with a stamped return envelope was attached. Participating GPs were asked to return the questionnaire within one month period of receiving the questionnaire. Results: The response rate in this study is 38%. Majority of the GPs (52.7%) used urine bag as method of collection and a single urine sample (56.8%) was used to diagnose UTI. Half of the samples taken (50%) were sent straight to the hospital for investigations. In the case of simple UTI, 67.6% of the GPs will commence the patient on oral antibiotic, usually amoxicillin-clavulanic acid (co-amoxiclav) (59.4%) for 5-7 days (79.7%). The referral rate for tertiary care was 59.5% of the cases. Conclusion: UTI can be challenging diagnosis especially in primary care setting. Implementation of UTI management according to local guideline is essential to prevent development of resistant organism.
Keywords: urinary tract infection, paediatrics, primary care, management
Correspondence author: Fahisham TAIB, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.
E mail: fahisham@gmail.com
Brunei Int Med J. 2015; 11 (1): 30-35