A survey of primary care physician practices in antibiotic prescribing for the treatment of uncomplicated male gonoccocal urethritis

BMC Family Practice

Research Article

François Lassau¹  Andrea Lasserre²  Veronique Massari²  Clément Turbelin²  Alessandra Falchi²  Thierry Blanchon²  Thomas Hanslik³  Patrice Sednaoui⁴  Anne Gallay⁵ 

[1] Hôpital Saint-Louis, AP-HP, Paris, France;INSERM, UMPC UMR-S 707, F-75012, Paris, France;UPMC Université Paris 06, UMR-S U707, F-75012, Paris, France;INSERM, UMPC UMR-S 707, F-75012, Paris, France;Université Versailles Saint Quentin en Yvelines, F-78000, Versailles, France;Assistance Publique Hôpitaux de Paris, Service de Médecine Interne, Hôpital Ambroise Paré, F-92100, Boulogne Billancourt, France;Institut Alfred Fournier, Paris, France;Institut de Veille Sanitaire, Paris, St Maurice, France;

关键词: Ceftriaxone;    Azithromycin;    Antibiotic Prescription;    Cefixime;    Neisseria Gonorrhoeae;   

DOI  :  10.1186/1471-2296-12-35

 received in 2010-10-01, accepted in 2011-05-18,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundThe development of resistance to antimicrobial therapy by Neisseria gonorrhoeae causes on-going problems for individual case management of gonorrhoea. Surveillance data about N. gonorrhoeae have indicated an increase in the incidence of gonorrhoea in France in 2006. As a consequence of the development of antibiotic resistance in N. gonorrhoeae, French guidelines excluded fluoroquinolones as a standard treatment for N. gonorrhoeae. Ceftriaxone became the recommended treatment, associated with azithromycin for Clamydia trachomatis infection. Our aim was to describe the practice patterns of general practitioners (GPs) in managing the antibiotic treatment of patients with symptoms suggestive of uncomplicated male urethritis.MethodsWe developed a clinical vignette describing a man with typical gonococcal urethritis symptoms to elicit questions about antibiotic treatment. We mailed the electronic questionnaire to a random sample of 1000 French GPs belonging to the Sentinelles Network.ResultsBy the end of the survey period, 350 vignettes were received, yielding a response rate of 35%. Sixty-six GPs (20.2%) prescribed the recommended antibiotics for the simultaneous treatment of N. gonorrhoeae and C. trachomatis infections, while 132 GPs (40.4%) prescribed only non-recommended antibiotics, including ciprofloxacin in 69 cases (21.1%). General practitioners with less than 10 years in practice showed better compliance to guidelines than those with more years in practice (p < 0.05).ConclusionsThe results suggest a mismatch between the guidelines and the antibiotic treatment of male uncomplicated urethritis by French GPs, mostly among the subgroup of physicians who have been in practice longer. Educational approaches based on practice feedback need to be developed to improve these deficits in the quality of care.

【 授权许可】

CC BY   
© Falchi et al; licensee BioMed Central Ltd. 2011