Author/Editor		Bajc, Irena; Petek-Šter, Marija; Živčec-Kalan, Gordana; Klančič, Dean; Kersnik, Janko
Title		Obravnava bolnic z nezapleteno okužbo sečil v družinski medicini
Translated title		Management of uncomplicated lower urinary tract infection of women in family practice
Type		članek
Source		Zdrav Vars
Vol. and No.		Letnik 47, št. 4
Publication year		2008
Volume		str. 179-86
Language		slo
Abstract		Background: Acute cystitis is one of the most common bacterial infections encountered in family physician's office. The aim of this study was to highlight some aspects of managing this infection and to survey the adherence of Slovenian physicians to the national recommendations for using trimethoprim-sulphmetoxazole as a first-line drug. Methods: The study was based on a cross-sectional study of Slovene family physicians' performance. A random sample of 42 physicians participated in the survey. The study took place between 1 October 2003 and 31March 2004.In total, 12,596 contacts were registered. The physicians were asked to fill in the questionnaire for each patient-doctor encounter. The questionnaire included patient data (sex, age, educational level), reason for the visit, diagnostic and therapeutic procedures, diagnoses, number of days away from work and a possible follow-up visit. The physicians were also instructed to measure the duration of each visit. Eligible visits were limited to those by women aged 18 to 65 years diagnosed with uncomplicated acute cystitis or urinary tract infection (N=64). Results: Sixty-four out of 4,388 of women aged 18 to 65 years presented with uncomplicated urinary tract infection.The visit of a patient with uncomplicated urinary tract infection lasted 7.6 minutes. In 53.1% of cases the diagnosis was based on history, physical examination and urine sample testing without obtaining urine culture. In 71.9% of cases trimethoprim-sulphametoxasol was prescribed as first-line therapy. A total of 60.9% of the patients were scheduled for a follow-up visit in a mean time of 7.7 days. Sick-leave was prescribed to 20.3% of the patients, and only 16 (25%) of the patients had appropriate follow-up requiring no sick-leave or follow-up visits. (Abstract truncated at 2000 characters)
Summary		Izhodišča: Nezapletena okužba sečil je ena najpogostejših bakterijskih bolezni, s katerimi se srečuje zdravnik družinske medicine. Namen raziskave je bil ugotoviti, kako to bolezen obravnavajo in v kolikšni meri upoštevajo nacionalna priporočila za uporabo trimetoprim-sulfometoksazola kot zdravila prve izbire. Bolniki in metode: Raziskava je zasnovana na presečni študiji dela slovenskih zdravnikov družinske medicine. Vanjo je bilo zajetih 42 naključno izbranih zdravnikov družinske medicine, ki so v času od 1. oktobra 2003 do 31. marca 2004 beležili obiske v svojih ambulantah in izpolnjevali vprašalnik o svojem delu. Od 12.596 zabeleženih stikov jih je 64 ustrezalo pogojem za uvrstitev v končni vzorec žensk, starih od 18 do 65 let, z ugotovljeno nezapleteno okužbo sečil. Obrazec je vključeval podatke o spolu, starosti in izobrazbi bolnic, razlogu za obisk, diagnostične in terapevtske postopke, diagnoze in odobritev bolniškega staleža ter morda naročeni kontrolni pregled. Zdravniki so merili tudi trajanje obiska. V vzorec so se uvrstile ženske v starosti med 18 in 65 leti z diagnosticirano nezapleteno okužbo spodnjih sečil (64 bolnic). Rezultati: 64 od 4388 bolnic v starostni skupini 18 do 65 let (1,5%) je imelo nezapleteno okužbo sečil. Povprečni obisk bolnic z nezapleteno okužbo sečil je trajal 7,6 min. Pri 53,1% bolnicah so zdravniki postavili diagnozo na podlagi anamneze in morebitnega pregleda urina brez urinokulture. Trimetoprim-sulfometoksazol (TMA +SMA) je bil kot zdravilo prve izbire predpisan pri 71,9% bolnic. 60,9% bolnic je bilo naročenih na ponovno kontrolo v povprečju čez 7,7 dni, 20,3% bolnic je zaradi nezapletene okužbe sečil koristilo bolniški stalež. Ustrezno spremljanje, ki ne zahteva kontrolnega pregleda in bolniškega staleža je bilo prisotno pri 16 (25,0%) bolnicah. (Izvleček prekinjen pri 2000 znakih)