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Treatment of urinary tract infection - multimodal intervention improves adherence to guidelines

PD Dr. Guido Schmiemann, Department of Health Service Research at the IPP, was involved in the research project on behalf of the University of Bremen.

Inappropriate prescription of antibiotics leads to increasing resistance. In order to improve the treatment for uncomplicated urinary tract infections in GP practices, the effects of an intervention program were examined as part of the RedAres study.

In addition to the University of Bremen, the Robert Koch Institute and the university departments of general medicine in Freiburg, Jena, Berlin and Würzburg were also involved in the project, which was supported by the Innovation Fund.

The results of this study have just been published in the British Medical Journal (

A total of 128 practices took part in the study. Practices in the intervention group received a summary of the current guideline recommendations as well as regional resistance data. These were collected nationwide in collaboration with the Robert Koch Institute and provided the participating practices with regional resistance data. At the same time, the practices also received individualized feedback on their prescribing behavior. On the one hand, the intervention resulted in fewer antibiotics being prescribed. This corresponds to the recommendations of the guideline, according to which non-antibiotic treatment is often possible and sufficient. On the other hand, the proportion of non-recommended antibiotics was reduced by 13 percentage points. The results of the study indicate a high degree of feasibility and acceptance of the intervention in GP practices. The reduced use of second-choice antibiotics is an important aspect of a rational antibiotic use.

Study website:

Schmiemann G, Greser A, Maun A, Bleidorn J, Schuster A, Miljukov O et al. Effects of a multimodal intervention in primary care to reduce second line antibiotic prescriptions for urinary tract infections in women: parallel, cluster randomized, controlled trial BMJ 2023; 383 :e076305 doi:10.1136/bmj-2023-076305

Contact: PD Dr. Guido Schmiemann, MPH

Institute for Public Health and Nursing Research
Department of Health Services Research



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