Predictive value of the urinary dipstick test in the management of patients with urinary tract infection-associated symptoms in primary care in Indonesia: a cross-sectional study

ObjectiveTo assess the test characteristics of a urine dipstick test in predicting a positive urine culture in an outpatient setting in Indonesia.DesignCross-sectional study.SettingTwo outpatient clinics in Medan, Indonesia.Participants616 consecutively enrolled participants suspected of having a ur...

Full description

Saved in:
Bibliographic Details
Published in:BMJ open 2018-08, Vol.8 (8), p.e023051-e023051
Main Authors: Ginting, Franciscus, Sugianli, Adhi Kristianto, Kusumawati, R Lia, Parwati, Ida, de Jong, Menno D, Schultsz, Constance, van Leth, Frank
Format: Article
Language:English
Subjects:
Accuracy
Adult
Ambulatory Care Facilities
Antibiotics
Antimicrobial agents
Cross-Sectional Studies
Diagnostics
Disease control
Drug resistance
Female
Health facilities
Hospitals
Humans
Indonesia
Male
Medical laboratories
Middle Aged
Population
Predictive Value of Tests
Pregnancy
Primary care
Primary Health Care
Surveillance
Systematic review
Urinalysis
Urinary tract diseases
Urinary tract infections
Urinary Tract Infections - complications
Urinary Tract Infections - diagnosis
Urinary Tract Infections - therapy
Urine
Urogenital system
Urology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:ObjectiveTo assess the test characteristics of a urine dipstick test in predicting a positive urine culture in an outpatient setting in Indonesia.DesignCross-sectional study.SettingTwo outpatient clinics in Medan, Indonesia.Participants616 consecutively enrolled participants suspected of having a urinary tract infection.Outcome measuresThe primary outcome is the estimates of accuracy (sensitivity, specificity, predictive values) where urine culture is the reference test. The secondary outcome is the post-test probability of a positive urine culture.ResultsThe optimal test characteristics were obtained when index test positivity was defined as any leucocyte esterase reaction and/or a nitrite reaction and reference test positivity was defined as a urine culture with a growth of at least 103 colony-forming units/mL (sensitivity: 88.2% (95% CI 81.6 to 93.1), negative predictive value: 93.0% (95% CI 88.9 to 95.9)). The post-test probability of a positive urine culture after a negative urinary dipstick test was 7% in the obstetric/gynaecology clinic and 8% in the internal medicine clinic.ConclusionThe use of a urine dipstick test in a rule-out strategy can reduce the need for urine culture and avoid the prescription of (ineffective) antibiotics in a non-urology outpatient setting.
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2018-023051