Reducing misdiagnosis of urinary tract infection in older adults
Research type
Research Study
Full title
Reducing misdiagnosis and antibiotic prescribing practices in hospitals: a case series review and qualitative study of diagnosis, management and treatment of urinary tract infections in adults aged over 70 years.
IRAS ID
202255
Contact name
Beryl Oppenheim
Contact email
Sponsor organisation
Birmingham Community Healthcare NHS Foundation Trust
Duration of Study in the UK
0 years, 6 months, 2 days
Research summary
Urinary tract infection (UTI) is the second most common clinical reason for antibiotic treatment in primary and secondary care. The NICE quality standard for the diagnosis of UTIs for adults over 65 years states that diagnosis and treatment should be based on a full clinical assessment. However, clinicians have highlighted that these guidelines are not followed in hospitals and that, in particular, urinary dipsticks (reagent strip tests) are commonly employed inappropriately or in isolation, leading to high rates of false positive results. An estimated 40% of cases of UTI in over 65 year olds are misdiagnosed, leading to over-prescribing of antibiotics. This has detrimental consequences to the patient and contributes to the emergence of antibiotic resistance.
To tackle this problem we propose to:
1. Document the current hospital practices for admission, diagnosis and treatment of UTIs among adults over 70 years old.
2. Estimate the level of over-prescribing of antibiotics for urinary bacteriuria (bacteria in urine not associated with infection).
3. Conduct qualitative interviews with a selection of hospital nurses, doctors and managers to understand the reasons for current practice.
4. Conduct qualitative interviews with patients to understand their experiences of diagnosis and treatment of UTIs.The combined qualitative and quantitative insights will be used to inform the development of an intervention that will reduce misdiagnosis and antibiotic prescribing and improve patient health outcomes.
REC name
West Midlands - Black Country Research Ethics Committee
REC reference
16/WM/0316
Date of REC Opinion
30 Aug 2016
REC opinion
Further Information Favourable Opinion