Unmet needs in uncomplicated urinary tract infection in the United States and Germany: a physician survey

Abstract Background Uncomplicated urinary tract infections (uUTIs/acute cystitis) are among the most common infections in women worldwide. There are differences in uUTI treatment guidelines between countries and understanding the needs of physicians in diverse healthcare systems is important for dev...

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Main Authors: Megan O’Brien, Alen Marijam, Fanny S. Mitrani-Gold, Laura Terry, Gavin Taylor-Stokes, Ashish V. Joshi
Format: Article
Language:English
Published: BMC 2023-05-01
Series:BMC Infectious Diseases
Subjects:
Online Access:https://doi.org/10.1186/s12879-023-08207-x
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author Megan O’Brien
Alen Marijam
Fanny S. Mitrani-Gold
Laura Terry
Gavin Taylor-Stokes
Ashish V. Joshi
author_facet Megan O’Brien
Alen Marijam
Fanny S. Mitrani-Gold
Laura Terry
Gavin Taylor-Stokes
Ashish V. Joshi
author_sort Megan O’Brien
collection DOAJ
description Abstract Background Uncomplicated urinary tract infections (uUTIs/acute cystitis) are among the most common infections in women worldwide. There are differences in uUTI treatment guidelines between countries and understanding the needs of physicians in diverse healthcare systems is important for developing new treatments. We performed a survey of physicians in the United States (US) and Germany to understand their perceptions of, and management approaches to uUTI. Methods This was a cross-sectional online survey of physicians in the US and Germany who were actively treating patients with uUTI (≥ 10 patients/month). Physicians were recruited via a specialist panel and the survey was piloted with 2 physicians (1 US, 1 Germany) prior to study commencement. Data were analyzed with descriptive statistics. Results A total of 300 physicians were surveyed (n = 200 US, n = 100 Germany). Across countries and specialties, physicians estimated 16–43% of patients did not receive complete relief from initial therapy and 33–37% had recurrent infections. Urine culture and susceptibility testing was more common in the US and among urologists. The most commonly selected first-line therapy was trimethoprim-sulfamethoxazole in the US (76%) and fosfomycin in Germany (61%). Ciprofloxacin was the most selected following multiple treatment failures (51% US, 45% Germany). Overall, 35% of US and 45% of German physicians agreed with the statement “I feel there is a good selection of treatment options” and ≥ 50% felt that current treatments provided good symptom relief. More than 90% of physicians included symptom relief amongst their top 3 treatment goals. The overall impact of symptoms on patients’ lives was rated “a great deal” by 51% of US and 38% of German physicians, increasing with each treatment failure. Most physicians (> 80%) agreed that antimicrobial resistance (AMR) is serious, but fewer (56% US, 46% Germany) had a high level of confidence in their knowledge of AMR. Conclusions Treatment goals for uUTI were similar in the US and Germany, although with nuances to disease management approaches. Physicians recognized that treatment failures have a significant impact on patients’ lives and that AMR is a serious problem, though many did not have confidence in their own knowledge of AMR.
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spelling doaj.art-0467fe725c0244dfb97107cb140ad1dd2023-05-07T11:06:57ZengBMCBMC Infectious Diseases1471-23342023-05-0123111710.1186/s12879-023-08207-xUnmet needs in uncomplicated urinary tract infection in the United States and Germany: a physician surveyMegan O’Brien0Alen Marijam1Fanny S. Mitrani-Gold2Laura Terry3Gavin Taylor-Stokes4Ashish V. Joshi5Adelphi Real WorldGSKGSKAdelphi Real WorldAdelphi Real WorldGSKAbstract Background Uncomplicated urinary tract infections (uUTIs/acute cystitis) are among the most common infections in women worldwide. There are differences in uUTI treatment guidelines between countries and understanding the needs of physicians in diverse healthcare systems is important for developing new treatments. We performed a survey of physicians in the United States (US) and Germany to understand their perceptions of, and management approaches to uUTI. Methods This was a cross-sectional online survey of physicians in the US and Germany who were actively treating patients with uUTI (≥ 10 patients/month). Physicians were recruited via a specialist panel and the survey was piloted with 2 physicians (1 US, 1 Germany) prior to study commencement. Data were analyzed with descriptive statistics. Results A total of 300 physicians were surveyed (n = 200 US, n = 100 Germany). Across countries and specialties, physicians estimated 16–43% of patients did not receive complete relief from initial therapy and 33–37% had recurrent infections. Urine culture and susceptibility testing was more common in the US and among urologists. The most commonly selected first-line therapy was trimethoprim-sulfamethoxazole in the US (76%) and fosfomycin in Germany (61%). Ciprofloxacin was the most selected following multiple treatment failures (51% US, 45% Germany). Overall, 35% of US and 45% of German physicians agreed with the statement “I feel there is a good selection of treatment options” and ≥ 50% felt that current treatments provided good symptom relief. More than 90% of physicians included symptom relief amongst their top 3 treatment goals. The overall impact of symptoms on patients’ lives was rated “a great deal” by 51% of US and 38% of German physicians, increasing with each treatment failure. Most physicians (> 80%) agreed that antimicrobial resistance (AMR) is serious, but fewer (56% US, 46% Germany) had a high level of confidence in their knowledge of AMR. Conclusions Treatment goals for uUTI were similar in the US and Germany, although with nuances to disease management approaches. Physicians recognized that treatment failures have a significant impact on patients’ lives and that AMR is a serious problem, though many did not have confidence in their own knowledge of AMR.https://doi.org/10.1186/s12879-023-08207-xAntibioticsUncomplicated urinary tract infectionPrimary careSecondary careSurvey
spellingShingle Megan O’Brien
Alen Marijam
Fanny S. Mitrani-Gold
Laura Terry
Gavin Taylor-Stokes
Ashish V. Joshi
Unmet needs in uncomplicated urinary tract infection in the United States and Germany: a physician survey
BMC Infectious Diseases
Antibiotics
Uncomplicated urinary tract infection
Primary care
Secondary care
Survey
title Unmet needs in uncomplicated urinary tract infection in the United States and Germany: a physician survey
title_full Unmet needs in uncomplicated urinary tract infection in the United States and Germany: a physician survey
title_fullStr Unmet needs in uncomplicated urinary tract infection in the United States and Germany: a physician survey
title_full_unstemmed Unmet needs in uncomplicated urinary tract infection in the United States and Germany: a physician survey
title_short Unmet needs in uncomplicated urinary tract infection in the United States and Germany: a physician survey
title_sort unmet needs in uncomplicated urinary tract infection in the united states and germany a physician survey
topic Antibiotics
Uncomplicated urinary tract infection
Primary care
Secondary care
Survey
url https://doi.org/10.1186/s12879-023-08207-x
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