Quick decision aid improves treatment of acute cystitis

A simplified three-item decision aid could help physicians avoid unnecessary antibiotic prescriptions and urine culture testing in women with symptoms of acute cystitis, according to a study published in the Nov. 12 issue of the Archives of Internal Medicine.

Warren J. McIsaac, MD, of Mount Sinai Hospital in Toronto, Canada, and colleagues assessed the decision aid's effectiveness in treatment decisions involving 331 women with suspected cystitis.

The researchers found that the decision aid's three variables-dysuria, the presence of more than a trace amount of leukocytes, and the presence of nitrites-were predictive of a positive urine culture result. They also found that the decision aid-which specifies empirical antibiotics without culture in the presence of two or more variables, and otherwise obtaining a culture and waiting for results-had a sensitivity of 80.3% and a specificity of 53.7%.

McIsaac WJ, Moineddin R, Ross S. Validation of a decision aid to assist physicians in reducing unnecessary antibiotic drug use for acute cystitis Arch Intern Med. 2007;167:2201-2206.