Perceived Knowledge, Guidelines Concordance, and Practices of Physicians for Management of Recurrent Urinary Tract Infections in Women

Abstract

Dana Aldabeeb,1 Ebtihag O Alenzi,2 Maysoon Alhaizan,3 Mashael Alkhattabi,3 Mazin Barry,4,5 Nouf Khalid Alalshaikh,6 Mohamad-Hani Temsah,7,8 Jaffar A Al-Tawfiq,9– 11 Ghadeer Alshaikh1 1Department of Obstetrics and Gynecology, King Saud University, Riyadh, 11587, Saudi Arabia; 2Family and Community Medicine Department, College of Medicine, Princess Nourah bint Abdulrahman University 11671, Riyadh, Saudi Arabia; 3Department of Obstetrics and Gynecology, King Saud University Medical City, King Saud University, Riyadh, 11587, Saudi Arabia; 4Department of Internal Medicine College of Medicine, King Saud University, Riyadh, 11587, Saudi Arabia; 5Department of Internal Medicine, College of Medicine, University of Ottawa, Ottawa, ON, K1H 8M5, Canada; 6College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, 6660, Saudi Arabia; 7Pediatric Department, College of Medicine, King Saud University, Riyadh, 11587, Saudi Arabia; 8Evidence-Based Health Care & Knowledge Translation Research Chair, King Saud University, Riyadh, 11587, Saudi Arabia; 9Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; 10Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, IN, USA; 11Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD, USACorrespondence: Dana Aldabeeb, Department of Obstetrics and Gynecology, King Saud University, Riyadh, Saudi Arabia, PO Box 2549-12434, Tel [phone], Email [email protected] Mohamad-Hani Temsah, Evidence-Based Health Care & Knowledge Translation Research Chair, Family & Community Medicine Department, College of Medicine, King Saud University, Riyadh, 11362, Saudi Arabia, Tel [phone], Email [email protected]: Recurrent urinary tract infections (rUTIs) are common complaints that burden the healthcare system. Reporting perceived knowledge and guidelines in concordance regarding the management of (rUTI) is essential for providing better healthcare and higher treatment rate. This study assesses the perceived knowledge, guidelines concordance, and physicians’ practices toward treatment of (rUTI) among physicians with different specialties.Study Design: This questionnaire-based survey included residents, fellows, and consultants of various specialties across several regions in Saudi Arabia.Results: A total of 419 physicians were included in the final analysis. In terms of age distribution, the majority were 28– 38 years of age (159, 37.9%), followed by 18– 28 years (99, 23.6%). Gender distribution was nearly balanced. The sample included a significant number of residents (182, 43.4%), consultants (173, 41.3%), and fellows (64, 15.3%). OBS/GYNE shows a significant presence of females (40.6%) and is notably represented in private hospitals or clinics (52.5%) and among fellows (40.6%) and consultants (32.4%). Infectious disease physicians had the highest perceived knowledge scores (3.83 ± 0.09), followed closely by urologists/urogynecologists (3.67 ± 0.48). Urologists/urogynecologists also reported the highest satisfaction (4.24 ± 0.83) and familiarity (2.89 ± 1.11) with new rUTI guidelines. Infectious disease physicians were most confident (3.50 ± 0.71) in communicating with patients about rUTI treatment options. In terms of practices and guideline adherence, obstetricians/gynaecologists were more likely to repeat urine sample tests for suspected contamination (3.73 ± 1.00) and less likely to treat asymptomatic bacteriuria (1.33 ± 0.59) the same as UTIs compared to other physicians. They also scored highest in conducting post-treatment tests for asymptomatic patients (3.21 ± 1.37) and recommending vaginal estrogen therapy for peri- and post-menopausal women to prevent UTIs (3.59 ± 1.06) among all specialties. Conversely, urologists and urogynecologists were more likely to discuss antibiotic prophylaxis (3.79 ± 0.89) and cranberry prophylaxis (3.71 ± 0.73) with their rUTI patients.Conclusion: The findings highlight variations in knowledge, satisfaction, familiarity with guidelines, confidence in communication, and guideline concordance among different physician specialities regarding the management of UTIs and rUTIs.Keywords: recurrent urinary tract infection, urologist, Saudi Arabia, gynecologists

Keywords

• recurrent urinary tract infection
• urologist
• saudi arabia
• gynecologists