Radiological investigations following urinary tract infection: changes in Australian practice

To examine practice changes in the conduct of radiological investigations in Australia following urinary tract infection (UTI).

Observational study using data from the national Medicare database over the 15-year period July 1993 to June 2008 for four investigations: renal ultrasound (renal US), micturating cystourethrography (MCU), intravenous pyelography (IVP) and nuclear medicine isotope scanning of the renal tract (NM). Rates per 100,000 children in the age groups 0-4 years and 5-14 years were calculated for each test.

Australian medical practice, including private and public medical settings.

The rates of performance of renal US remained fairly constant throughout the study period in both age groups, while those for MCU, IVP and NM showed a strong falling trend over time for each test in both age groups. For the more invasive tests (MCU, IVP and NM) the total number performed per annum fell from 11,169 (costing 2,032,621 dollars) to 3361 (costing 689,742 dollars) in the last 10 years.

There have been very marked practice changes over the last 10-15 years. This trend followed the publication of scientific evidence which has raised doubts about the benefit of performing these investigations.