In conjunction with the microbiology department at the Oxford Radcliffe
Hospital, we have been auditing whether the use of urine dip-sticks
(Multistix) affects our management of clinically suspected UTI's. The
sensitivity and specificity of urine testing sticks such as Multistix 8SG
and Nephurstix has been show to be very good in detecting urinary tract
infections in a variety of patient populations, and so the hypothesis was
that by using the test sticks it should be possible to reduce the high
number of MSU's sent to the lab which are negative, reduce blind AB Rx,
provide an immediate answer as to whether the patients urinary symptoms
were due to UTI (and the implication that this should improve management).
The cost equation driving this interest is that the laboratory costs of an
MSU are about 3.50, whereas a dip-stick costs approximately 18p.
Over a 7 month period we sent 53% fewer MSU's than in the preceeding 7
months. "Control" practices (similar list size in the area) sent 14% fewer
MSU's also.
We think this is rather encouraging. Certainly the dip sticks are
enthusiastically received by all (GP's, DN's, HV, PN). Has anyone on GP-UK
done any similar audit/research ? We would like to write it up but of
course it is only one practice's results. Is anyone out there interested in
taking part in a bigger study ?
Paul
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