Primary Care
A nurse led education and direct access service for the management of urinary tract infections in children: prospective controlled trial
BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7416.656 (Published 18 September 2003) Cite this as: BMJ 2003;327:656
Data supplement
Table A Numbers of children in study and control groups referred (those that subsequently underwent imaging investigations), according to certainty of diagnosis of urinary infection based on culture
Categories of diagnostic certainty No referred (No imaged) Study practices Control practices Unequivocal: >105/ml likely uropathogens 464 (442)* 180 (174)† Equivocal: >105/ml unlikely uropathogens‡, or heavy mixed growth 92 (75) 38 (35) Excluded: Urine culture sterile or <105/ml organisms 30 (15) 44 (40) No information: No urine collected 0 6 (6) Urine sample not cultured 5 (3) 25 (21) Total 591 (537) 293 (278) *Six who had had previous normal scan results were not imaged. Three had an additional diagnosis (two were imaged).
†Three who had had previous normal scan results were not imaged.
‡Included Enterococci, Streptococcus viridans, or Pseudomonas spp.
Table B Number and findings of micturating cystography in study and control children
Indication for cystography No performed (No with reflux) Study children Control children Aged <1 year 73 (12) 14 (0) Parenchymal abnormality 11 (7) 4 (1) Recurrent urinary tract infections aged <4 years 2 (0) 1 (1) Total 86 (19) 19 (2)
Table C Indicators of clinical management for children with urinary infection, comparing study practices with most control practices and to four practices with simple direct access
Clinical management Study practices (n=44) Controls practices (n=40) Control practices with direct access (n=4) Referrals (cases/1000 children/year) All ages 6.4 3.3 5.4 <1 year 0.9 0.3 0.3 Systemic symptoms only 1.4 0.3 0.3 Urine collection and culture (% of eligible): Correctly used potty aged 3 or 4 27 4 0 No urine culture available on referral 0.5 11 17 Prophylactic antibiotics <4 years (%) 94 41 43
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