Decision Aid Improves Treatment of Acute Cystitis

Three-item evaluation may help reduce unneeded antibiotic prescriptions and culture testing

WEDNESDAY, Nov. 14 (HealthDay News) -- A simplified three-item decision aid could help physicians avoid unnecessary antibiotic drug prescriptions and urine culture testing in women with symptoms of acute cystitis, according to a study published in the Nov. 12 issue of the Archives of Internal Medicine.

Warren J. McIsaac, M.D., of Mount Sinai Hospital in Toronto, Canada, and colleagues assessed the decision aid's effectiveness in treatment decisions involving 331 women with suspected cystitis.

The researchers found that the decision aid's three variables -- dysuria, the presence of more than a trace amount of leukocytes, and the presence of nitrites -- were predictive of a positive urine culture result. They also found that the decision aid -- which specifies empirical antibiotics without culture in the presence of two or more variables, and otherwise obtaining a culture and waiting for results -- had a sensitivity of 80.3 percent and a specificity of 53.7 percent.

"The cystitis decision aid is a simple clinical approach that could reduce practice variation as well as unnecessary antibiotic prescriptions and urine culture testing," the authors write. "In this community-based study of females with typical symptoms of acute cystitis, following decision aid recommendations would have reduced unnecessary antibiotic prescriptions by 40.2 percent and urine culture testing by 59 percent compared with observed physician care."

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