{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T01:10:56Z","timestamp":1780449056696,"version":"3.54.1"},"reference-count":35,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T00:00:00Z","timestamp":1729728000000},"content-version":"unspecified","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"The Netherlands Organisation for Health Research and Development","doi-asserted-by":"crossref","award":["10150511910060"],"award-info":[{"award-number":["10150511910060"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,9,17]]},"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Urinary tract infections (UTIs) are the most common reason for women to consult a general practitioner (GP). Current diagnostic tests are inadequate, complicating diagnosis and treatment decisions for GPs. To understand how this influences GPs in managing UTI, we aimed to determine GPs\u2019 knowledge, attitudes, and practices around UTI care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Cross-sectional internet-based survey.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>General practice in the Netherlands between December 2021 and February 2022.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>We distributed invitations to participate via email to 126 practices. Additionally, we distributed invitations via social media and newsletters.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>The survey included 15 questions covering GPs\u2019 sociodemographic information, knowledge, attitudes and practices. Data analysis was based on frequencies and descriptive statistics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among the 190 eligible respondents, 172 (90.5%) chose dysuria and 140 (73.7%) chose urinary frequency as a symptom likely indicating UTI in healthy women. One in three GPs would diagnose a UTI based on non-specific complaints with positive leucocyte and erythrocyte tests, discordant with established guidelines. GPs indicated that better point-of-care diagnostics would help improve antibiotic prescribing (72.6%) and would conserve time (60.0%). GPs considered a positive test result the most important factor to prescribe antibiotics while patient expectation was considered least important. Half of GPs indicated that the most urgent need in UTI care is improved diagnostics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>GPs often act in discordance with established guidelines, rely on non-specific symptoms for the diagnosis of UTI and rank patient expectation as less important in comparison to symptom recognition and culture result when deciding on antibiotic treatment.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-083263","type":"journal-article","created":{"date-parts":[[2024,10,26]],"date-time":"2024-10-26T07:55:43Z","timestamp":1729929343000},"page":"e083263","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Knowledge, attitudes and practices around urinary tract infections of general practitioners in the Netherlands: a cross-sectional internet survey"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6804-936X","authenticated-orcid":false,"given":"Stefan Martinus Leonardus","family":"Cox","sequence":"first","affiliation":[{"name":"Family Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wesley","family":"Giorgi","sequence":"additional","affiliation":[{"name":"Family Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5122-0079","authenticated-orcid":false,"given":"Tamara N","family":"Platteel","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9550-5674","authenticated-orcid":false,"given":"Jochen W L","family":"Cals","sequence":"additional","affiliation":[{"name":"Family Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2700-4752","authenticated-orcid":false,"given":"Eefje G P M","family":"de Bont","sequence":"additional","affiliation":[{"name":"Family Medicine, CAPHRI, Maastricht University, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,10,26]]},"reference":[{"key":"2025101810503646000_14.10.e083263.1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp15X686965"},{"key":"2025101810503646000_14.10.e083263.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2013.09.003"},{"key":"2025101810503646000_14.10.e083263.3","unstructured":"Hertogh C . De nieuwe richtlijn urineweginfecties: een paradigmashift [Tijdschr voor Ouderengeneesk]. 2018. Available: https:\/\/www.verenso.nl\/magazine-december-2018\/no-6-december-2018\/actueel\/de-nieuwe-richtlijn-urineweginfecties-een-paradigmashift#:~:text=De%20zojuist%20verschenen%20Verenso%20richtlijn,2006%20daterende%2C%20richtlijn%20zou%20gaan]"},{"key":"2025101810503646000_14.10.e083263.4","doi-asserted-by":"crossref","unstructured":"Bouma M , Geerlings SE , Klinkhamer S , et al . NHG-Standaard Urineweginfecties. 2020. Available: https:\/\/richtlijnen.nhg.org\/standaarden\/urineweginfecties","DOI":"10.1007\/s12445-020-0584-y"},{"key":"2025101810503646000_14.10.e083263.5","doi-asserted-by":"crossref","DOI":"10.1186\/s12875-020-01305-8","article-title":"Workload, diagnostic work-up and treatment of urinary tract infections in adults during out-of-hours primary care: a retrospective cohort study","volume":"21","author":"Spek","year":"2020","journal-title":"BMC Fam Pract"},{"key":"2025101810503646000_14.10.e083263.6","doi-asserted-by":"crossref","first-page":"265","DOI":"10.4103\/2249-4863.154672","article-title":"Reliability of dipstick assay in predicting urinary tract infection","volume":"4","author":"Mambatta","year":"2015","journal-title":"J Family Med Prim Care"},{"key":"2025101810503646000_14.10.e083263.7","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2490-4-1"},{"key":"2025101810503646000_14.10.e083263.8","first-page":"99","article-title":"Asymptomatic Bacteriuria","volume":"102","author":"Colgan","year":"2020","journal-title":"Am Fam Physician"},{"key":"2025101810503646000_14.10.e083263.9","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/20.2.103"},{"key":"2025101810503646000_14.10.e083263.10","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmt077"},{"key":"2025101810503646000_14.10.e083263.11","unstructured":"Batenburg R , Velden L , Vis E , et al . Cijfers uit de registratie van huisartsen\u2013een update van de werkzaamheidscijfers voor 2018 en 2019. 2019."},{"key":"2025101810503646000_14.10.e083263.12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11908-019-0668-7","article-title":"Advances and Challenges in the Diagnosis and Treatment of Urinary Tract Infections: the Need for Diagnostic Stewardship","volume":"21","author":"Claeys","year":"2019","journal-title":"Curr Infect Dis Rep"},{"key":"2025101810503646000_14.10.e083263.13","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2022-072319","article-title":"Effect of a multifaceted antibiotic stewardship intervention to improve antibiotic prescribing for suspected urinary tract infections in frail older adults (ImpresU): pragmatic cluster randomised controlled trial in four European countries","volume":"380","author":"Hartman","year":"2023","journal-title":"BMJ"},{"key":"2025101810503646000_14.10.e083263.14","unstructured":"Hooton TM , Gupta K . Acute Simple Cystitis in Women. Waltham, MA: UpToDate Inc, 2018."},{"key":"2025101810503646000_14.10.e083263.15","first-page":"729","article-title":"Randomised controlled trial of nitrofurantoin versus placebo in the treatment of uncomplicated urinary tract infection in adult women","volume":"52","author":"Christiaens","year":"2002","journal-title":"Br J Gen Pract"},{"key":"2025101810503646000_14.10.e083263.16","doi-asserted-by":"publisher","DOI":"10.1080\/00365540410019642"},{"key":"2025101810503646000_14.10.e083263.17","first-page":"778","article-title":"Dysuria: evaluation and differential diagnosis in adults","volume":"92","author":"Michels","year":"2015","journal-title":"Am Gen Pract"},{"key":"2025101810503646000_14.10.e083263.18","doi-asserted-by":"publisher","DOI":"10.1001\/jama.287.20.2701"},{"key":"2025101810503646000_14.10.e083263.19","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.c279","article-title":"Women\u2019s views about management and cause of urinary tract infection: qualitative interview study","volume":"340","author":"Leydon","year":"2010","journal-title":"BMJ"},{"key":"2025101810503646000_14.10.e083263.20","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.20.2201"},{"key":"2025101810503646000_14.10.e083263.21","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1513"},{"key":"2025101810503646000_14.10.e083263.22","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X10391671"},{"key":"2025101810503646000_14.10.e083263.23","doi-asserted-by":"crossref","DOI":"10.3390\/antibiotics12020241","article-title":"Patients\u2019 Experiences, Expectations, Motivations, and Perspectives around Urinary Tract Infection Care in General Practice: A Qualitative Interview Study","volume":"12","author":"Cox","year":"2023","journal-title":"Antibiotics (Basel)"},{"key":"2025101810503646000_14.10.e083263.24","unstructured":"Stefan S , Nicolas D , Thierry C . Richtlijn Cystitis Bij de Vrouw. Herziening 2016. Domus Medicus, 2016."},{"key":"2025101810503646000_14.10.e083263.25","unstructured":"S3-Leitlinie Epidemiologie, Diagnostik, Therapie, Pr\u00e4vention Und Management Unkomplizierter, Bakterieller, Ambulant Erworbener Harnwegsinfektionen Bei Erwachsenen (HWI) (Kurzversion) . Arbeitsgemeinschaft der wissenschaftlichen medizinischen fachgesellschaften. 2024."},{"key":"2025101810503646000_14.10.e083263.26","unstructured":"Folkh\u00e4lsomyndigheten L . Behandlingsrekommendationer f\u00f6r vanliga infektioner i \u00f6ppenv\u00e5rd. 2023."},{"key":"2025101810503646000_14.10.e083263.27","unstructured":"Helsedirektoratet . Akutt cystitt hos ikke-gravid kvinne 15 - 65 \u00e5r antibiotikasenteret for primaermedisin. 2022. Available: https:\/\/antibiotikaiallmennpraksis.no\/index.php?action=topic&item=f652b4a03e5ba0f653aa [Accessed 10 Jun 2024]."},{"key":"2025101810503646000_14.10.e083263.28","unstructured":"Diagnosis of urinary tract infections. quick reference tool for primary care for consultation and local adaptation. Public Health England; 2020."},{"key":"2025101810503646000_14.10.e083263.29","unstructured":"Dansk Selskab for Almen Medicin (DSAM) . Urinvejsinfektioner i almen praksis. 2020. Available: https:\/\/www.dsam.dk\/vejledninger\/urinvejsinfektioner\/urinvejsinfektioner-i-almen-praksis#diagnostik"},{"key":"2025101810503646000_14.10.e083263.30","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.medmal.2018.03.005","article-title":"Practice guidelines for the management of adult community-acquired urinary tract infections","volume":"48","author":"Caron","year":"2018","journal-title":"Med Mal Infect"},{"key":"2025101810503646000_14.10.e083263.31","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-135-1-200107030-00004"},{"key":"2025101810503646000_14.10.e083263.32","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1080\/23744235.2020.1834138","article-title":"Uncomplicated urinary tract infection in primary health care: presentation and clinical outcome","volume":"53","author":"Kornf\u00e4lt Isberg","year":"2021","journal-title":"Infect Dis (Lond)"},{"key":"2025101810503646000_14.10.e083263.33","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-027221","article-title":"Trends of prescribing antimicrobial drugs for urinary tract infections in primary care in the Netherlands: a population-based cohort study","volume":"9","author":"Mulder","year":"2019","journal-title":"BMJ Open"},{"key":"2025101810503646000_14.10.e083263.34","doi-asserted-by":"crossref","DOI":"10.3390\/antibiotics5030027","article-title":"Exploring Experiences of Delayed Prescribing and Symptomatic Treatment for Urinary Tract Infections among General Practitioners and Patients in Ambulatory Care: A Qualitative Study","volume":"5","author":"Duane","year":"2016","journal-title":"Antibiotics (Basel)"},{"key":"2025101810503646000_14.10.e083263.35","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2021-059978","article-title":"Cross-sectional internet survey exploring women\u2019s knowledge, attitudes and practice regarding urinary tract infection-related symptoms in the Netherlands","volume":"12","author":"Cox","year":"2022","journal-title":"BMJ Open"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-083263","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T17:50:45Z","timestamp":1760809845000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-083263"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10]]},"references-count":35,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2024,10,26]]},"published-print":{"date-parts":[[2024,10]]}},"alternative-id":["10.1136\/bmjopen-2023-083263"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-083263","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10]]}}}