Exploring the real-world management of catheter-associated urinary tract infections by Swiss general practitioners and urologists: insights from an online survey.

Abstract

Aim: To assess and compare the real-world management of catheters and catheter-associated urinary tract infections (CAUTI) among Swiss general practitioners and urologists, encompassing diagnosis, treatment and prophylaxis.

Methods: An anonymised online questionnaire was distributed among Swiss general practitioners and urologists between January and October 2023 via the networks of Sentinella and the Swiss Association of Urology. The questionnaire consisted of questions on catheter management, including diagnosis, treatment and prophylaxis of CAUTI. Analysis was performed by discipline. Fisher's exact test was applied for comparisons (statistical significance with p <0.05).

Results: Out of 175 participating physicians, the majority were involved in catheter management. Urologists exhibited significantly higher levels of competence as compared to general practitioners (67.1% vs 20.9%). Although no significant differences were observed regarding diagnostic approaches between disciplines, unrecommended diagnostic methods were frequently applied. general practitioners reported that they treated non-febrile CAUTI for longer durations, while urologists indicated that they treated febrile CAUTI longer. Additionally, the use of fluoroquinolones was more prevalent among general practitioners compared to urologists, while prophylactic measures were more frequently applied by urologists.

Conclusions: Catheter and CAUTI management entail significant uncertainty for general practitioners. CAUTI management varied notably between general practitioners and urologists in terms of treatment and prophylaxis. The use of non-recommended diagnostic approaches and drugs was common. This trend, along with inappropriate diagnostic methods and prophylaxis, may increase antimicrobial resistance and CAUTI morbidity. The study emphasises the necessity for diagnostic and antimicrobial stewardship interventions, and proper training in CAUTI management for general practitioners and urologists.