Perceptions and behaviours of infectious diseases physicians when managing urinary tract infections due to MDR
Sergio E Trevino1, Hilary M Babcock1, Jeffrey P Henderson1
1Division of Infectious Diseases, Washington University School of Medicine, 660 S. Euclid, St Louis, MO 63110, USA.
Objectives:
The objective of this study was to attain a better understanding of infectious diseases (ID) physicians' experience with MDR organism (MDRO) urinary tract infections (UTIs) by means of a survey on disease perception, diagnostic management and treatment preferences.
Methods:
A nine-question survey was developed and distributed to members of the North American Emerging Infections Network (EIN) in September 2013.
Results:
Seven hundred and fourteen out of 1461 EIN members responded to the survey (49%). The responses of 603 responders were studied. Most providers perceived an increase in the incidence of MDRO UTIs over the past 3 years (75% of adult ID responders and 63% of paediatric ID responders). One hundred and thirty-four (22%) responders prefer intravenous over oral administration of antimicrobials when both are available, 171 (28%) prefer longer durations of therapy when comparing an MDRO with a susceptible isolate of the same species and 142 (24%) order a repeat urine culture as 'proof of cure' after treating an MDRO UTI. Nevertheless, 530 (88%) responders perceived MDRO UTIs to be of similar severity as non-MDRO UTIs. Fifty-five percent of providers prescribed fosfomycin for MDRO UTI at least once; the most common prescribing pattern (among a wide spectrum of approaches) was a single dose (16%).
Conclusions:
Future studies on MDRO UTIs should clarify the role of resistance in patient outcomes and the comparative efficacy of different antimicrobials. Of particular interest is fosfomycin, which is unrelated to other antibiotic classes and may take a more prominent role in treating MDRO cystitis.
Insights
Infectious disease physicians report increased multidrug-resistant organism (MDRO) urinary tract infections (UTIs). Fosfomycin is increasingly used, though treatment patterns vary, highlighting the need for further research on MDRO UTI management.
Area of Science:
- Infectious Diseases
- Urology
- Microbiology
Background:
- Multidrug-resistant organism (MDRO) urinary tract infections (UTIs) pose a growing challenge in healthcare.
- Understanding the perceptions and practices of infectious diseases (ID) physicians is crucial for effective management.
Purpose of the Study:
- To investigate ID physicians' experiences with MDRO UTIs.
- To assess perceptions of disease incidence, diagnostic approaches, and treatment preferences.
Main Methods:
- A survey was distributed to members of the North American Emerging Infections Network (EIN) in September 2013.
- Nine questions addressed disease perception, diagnostics, and treatment of MDRO UTIs.
Main Results:
- A majority of ID physicians perceived an increase in MDRO UTIs.
- Treatment preferences varied, with some favoring IV administration, longer durations, or repeat cultures.
- Fosfomycin was prescribed by 55% of providers, often as a single dose.
Conclusions:
- Further research is needed to clarify the impact of resistance on patient outcomes and compare antimicrobial efficacy for MDRO UTIs.
- Fosfomycin's unique mechanism suggests potential for treating MDRO cystitis.
