چکیده (انگلیسی):

Background:Urinary tract infections (UTI) are the most frequent bacterial infection affecting women and account
for about 15% of antibiotics prescribed in primary care. However, some women with a UTI are not prescribed
antibiotics or are prescribed the wrong antibiotics, while many women who do not have a microbiologically
confirmed UTI are prescribed antibiotics. Inappropriate antibiotic prescribing unnecessarily increases the risk of
side effects and the development of antibiotic resistance, and wastes resources.
POETIC is a randomised controlled trial of a Point Of Care Test (POCT) (Flexicult™) guided UTI management strategy
for use in primary care, which may help General Practitioners more effectively decide both whetheror not to
prescribe antibiotics, and if so, to select themost appropriateantibiotic.
Methods/design:614 adult female patients will be recruited from four primary care research networks (Wales,
England, Spain, the Netherlands) and individually randomised to either POCT guided care or the guideline-informed
‘standard care’ arm. Urine and stool samples (where possible) will be obtained at presentation (day 1) and two
weeks later for microbiological analysis. All participants will be followed up on the course of their illness and their
quality of life, using a 2 week self-completed symptom diary. At 3 months, a primary care notes review will be
conducted for evidence of further evidence of treatment failures, recurrence, complications, hospitalisations and
health service costs.
The primary objective is to compare appropriate antibiotic use on day 3 between the POCT and standard care arms
using multi-level logistic regression to produce an odds ratio and associated 95% confidence interval. Costs of the
two management approaches will be assessed in terms of the primary outcome.
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* Correspondence:Thomas-JonesE@cardiff.ac.uk
†
Equal contributors
1
South East Wales Trials Unit (SEWTU), School of Medicine, Cardiff University,
7th Floor Neuadd Meirionnydd, Heath Park, Cardiff CF14 4XN, UK
Full list of author information is available at the end of the article
© 2014 Bates et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain
Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article,
unless otherwise stated.
Bateset al. BMC Family Practice2014,15:187
http://www.biomedcentral.com/1471-2296/15/187
(Continued from previous page)
Discussion:Although the Flexicult™POCT is used in some countries in routine primary care, it’s clinical and cost
effectiveness has never been evaluated in a randomised clinical trial. If shown to be effective, the use of this POCT
could benefit individual sufferers and provide evidence for health care authorities to develop evidence based
policies to combat the spread and impact of the unprecedented rise of infections caused by antibiotic resistant
bacteria in Europe.
Trial registration number:ISRCTN65200697 (Registered 10 September 2013).