{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T06:05:02Z","timestamp":1782453902526,"version":"3.54.5"},"reference-count":84,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,7,14]],"date-time":"2022-07-14T00:00:00Z","timestamp":1657756800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The management of adult male urinary tract infections (mUTIs) in primary care lacks international consensus. The main objective of this study was to describe the different guidelines for the diagnosis and management of mUTIs in primary care, to assess their methodological quality, and to describe their evidence-based strength of recommendation (SoR).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>An international systematic literature review of the electronic databases Medline (PubMed) and EMBASE, and gray-literature guideline-focused databases was performed in 2021. The Appraisal of Guidelines for Research and Evaluation (AGREE II) assessment tool was used by 2 independent reviewers to appraise each guideline.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>From 1,678 records identified, 1,558 were screened, 134 assessed for eligibility, and 29 updated guidelines met the inclusion criteria (13 from Medline, 0 from EMBASE, and 16 from gray literature). Quality assessment revealed 14 (48%) guidelines with high-quality methodology. A grading system methodology was used in 18 (62%) guidelines. Different classifications of mUTIs are described, underlining a lack of international consensus: an anatomic classification (cystitis, prostatitis, pyelonephritis) and a symptomatic classification (approach based on the intensity and tolerance of symptoms). The duration of antibiotic treatment for febrile mUTIs has been gradually reduced over the last 20 years from 28 days to 10\u201314 days of fluoroquinolones (FQ), which has become the international gold standard. Guidelines from Scandinavian countries propose short courses (3\u20135 days) of FQ-sparing treatments: pivmecillinam, nitrofurantoin, or trimethoprim. Guidelines from French-speaking countries use a watchful waiting approach and suggest treating mUTIs with FQ, regardless of fever.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This lack of scientific evidence leads to consensus and disagreement: 14 days of FQ for febrile mUTIs is accepted despite a high risk of antimicrobial resistance, but FQ-sparing treatment and\/or short treatment for afebrile mUTIs is not. The definition of afebrile UTIs\/cystitis is debated and influences the type and duration of antibiotic treatment recommended.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/fampra\/cmac068","type":"journal-article","created":{"date-parts":[[2022,7,14]],"date-time":"2022-07-14T06:22:28Z","timestamp":1657779748000},"page":"152-175","source":"Crossref","is-referenced-by-count":14,"title":["Guidelines for the management of male urinary tract infections in primary care: a lack of international consensus\u2014a systematic review of the literature"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0529-0954","authenticated-orcid":false,"given":"Benjamin","family":"Soudais","sequence":"first","affiliation":[{"name":"Department of General Practice, Normandie Univ, UNIROUEN , F-76000 Rouen , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Ribeaucoup","sequence":"additional","affiliation":[{"name":"Department of General Practice, Normandie Univ, UNIROUEN , F-76000 Rouen , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7355-4560","authenticated-orcid":false,"given":"Matthieu","family":"Schuers","sequence":"additional","affiliation":[{"name":"Department of General Practice, Normandie Univ, UNIROUEN , F-76000 Rouen , France"},{"name":"Department of Biomedical Informatics, CHU Rouen , F-76000 Rouen , France"},{"name":"Sorbonne Universit\u00e9, LIMICS U1142 , F-75015 Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,7,14]]},"reference":[{"key":"2023020910215945300_CIT0001","author":"Nielen"},{"issue":"1","key":"2023020910215945300_CIT0002","doi-asserted-by":"crossref","first-page":"e0190521","DOI":"10.1371\/journal.pone.0190521","article-title":"Incidence and antibiotic prescribing for clinically diagnosed urinary tract infection in older adults in UK primary care, 2004\u20132014.","volume":"13","author":"Ahmed","year":"2018","journal-title":"PLoS ONE"},{"issue":"6","key":"2023020910215945300_CIT0003","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.medmal.2017.05.003","article-title":"Diagnostic strategies for urinary tract infections in French general practice.","volume":"47","author":"Kinouani","year":"2017","journal-title":"M\u00e9d Mal Infect"},{"issue":"4","key":"2023020910215945300_CIT0004","first-page":"189","article-title":"Mapping French terms in a Belgian guideline on heart failure to international classifications and nomenclatures: the devil is in the detail","volume":"21","author":"Jamoulle","year":"2014","journal-title":"Inform Prim Care"},{"key":"2023020910215945300_CIT0005","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1186\/1741-7015-9-57","article-title":"Predictive factors of urinary tract infections among the oldest old in the general population. a population-based prospective follow-up study.","volume":"9","author":"Caljouw","year":"2011","journal-title":"BMC Med"},{"issue":"1","key":"2023020910215945300_CIT0006","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1186\/s12875-021-01470-4","article-title":"Consultations and antibiotic treatment for urinary tract infections in Norwegian primary care 2006\u20132015, a registry-based study.","volume":"22","author":"Haugom","year":"2021","journal-title":"BMC Fam Pract"},{"issue":"4","key":"2023020910215945300_CIT0007","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1093\/fampra\/cmaa136","article-title":"Diagnosis and management of male urinary tract infections: a need for new guidelines. 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