چکیده (انگلیسی):

Background:Urinary tract infection (UTI) is a common infection in primary care and is the second leading reason
for prescription of antibiotics in Denmark. The diagnosis is often based on symptoms and urine dip-stick, which has
limited validity, causing the risk of unnecessary antibiotic prescription. Additionally, with increasing antibiotic resistance,
the risk of choosing an antibiotic to which an infecting pathogen is resistant is rising. Combined point-of-care-tests
(POCT) for urine culture and susceptibility testing have been developed and validated for primary care, and performing
such a test in all patients with suspected UTI in primary care seems rational in order to reduce the use of inappropriate
antibiotics. However, the clinical effect of the culture and susceptibility test has not yet been investigated. This study
aims to investigate whether POCT urine culture and susceptibility testing decreases the inappropriate use of antibiotics
and leads to faster patient recovery.
Methods/design:Randomized controlled open label trial of two diagnostic approaches. 750 patients with symptoms
of uncomplicated UTI, consecutively contacting their general practitioner (GP), randomized to either POCT urine culture
and susceptibility testing and targeted treatment or POCT urine culture without susceptibility testing and empirical
treatment. Treatment is started when the POCT is read. The two groups are compared with regard to appropriate
choice of antibiotics, clinical remission, and microbiological cure rates.
Discussion:The results of this study may provide important evidence to recommend POCT culture and
susceptibility testing in all patients with suspected uncomplicated UTI. This could become an additional
strategy to fight antibiotic resistance.