TY - JOUR
T1 - Management of suspected infectious diarrhoea by English GPs
T2 - are they right?
AU - McNulty, Cliodna A
AU - Lasseter, Gemma
AU - Verlander, Neville Q
AU - Yoxall, Harry
AU - Moore, Philippa
AU - O'Brien, Sarah J
AU - Evans, Mark
PY - 2014/1
Y1 - 2014/1
N2 - BACKGROUND The criteria used when GPs submit stool specimens for microbiological investigation are unknown. AIM To determine what criteria GPs use to send stool specimens, and if they are consistent with national guidance, and whether GPs would prescribe an antibiotic before they receive a result. DESIGN AND SETTING Questionnaire survey of 974 GPs in 172 surgeries in England. METHOD GPs were sent a questionnaire (23 questions) based on national guidance. RESULTS Questionnaires were returned by 90% (154/172) of surgeries and 49% (477/968) of GPs. GPs reported sending stool specimens in about 50% of cases of suspected infectious diarrhoea, most commonly because of individual symptoms, rather than public health implications. Fewer considered sampling with antibiotic-associated diarrhoea post hospitalisation, or children with acute, painful, bloody diarrhoea; only 14% mentioned outbreaks as a reason. Nearly one-half of GPs reported they would consider antibiotics in suspected cases of Escherichia coli O157, which is contraindicated. Only 23% of GPs would send the recommended three specimens for ova, cysts, and parasites (OCP) examination. Although 89% of GPs gave some verbal advice on how to collect stool specimens, only 2% of GPs gave patients any written instructions. CONCLUSION GPs need more education to address gaps in knowledge about the risks and diagnosis of different infections in suspected infectious diarrhoea, especially Clostridium difficile post-antibiotics, E. coli O157, and requesting OCPs. Advice on reports, tick boxes, or links to guidance on electronic request forms may facilitate this.
AB - BACKGROUND The criteria used when GPs submit stool specimens for microbiological investigation are unknown. AIM To determine what criteria GPs use to send stool specimens, and if they are consistent with national guidance, and whether GPs would prescribe an antibiotic before they receive a result. DESIGN AND SETTING Questionnaire survey of 974 GPs in 172 surgeries in England. METHOD GPs were sent a questionnaire (23 questions) based on national guidance. RESULTS Questionnaires were returned by 90% (154/172) of surgeries and 49% (477/968) of GPs. GPs reported sending stool specimens in about 50% of cases of suspected infectious diarrhoea, most commonly because of individual symptoms, rather than public health implications. Fewer considered sampling with antibiotic-associated diarrhoea post hospitalisation, or children with acute, painful, bloody diarrhoea; only 14% mentioned outbreaks as a reason. Nearly one-half of GPs reported they would consider antibiotics in suspected cases of Escherichia coli O157, which is contraindicated. Only 23% of GPs would send the recommended three specimens for ova, cysts, and parasites (OCP) examination. Although 89% of GPs gave some verbal advice on how to collect stool specimens, only 2% of GPs gave patients any written instructions. CONCLUSION GPs need more education to address gaps in knowledge about the risks and diagnosis of different infections in suspected infectious diarrhoea, especially Clostridium difficile post-antibiotics, E. coli O157, and requesting OCPs. Advice on reports, tick boxes, or links to guidance on electronic request forms may facilitate this.
KW - General Practice
KW - Infection
KW - management options
U2 - 10.3399/bjgp14X676429
DO - 10.3399/bjgp14X676429
M3 - Article (Academic Journal)
C2 - 24567579
SN - 1478-5242
VL - 64
SP - e24-30
JO - British Journal of General Practice
JF - British Journal of General Practice
IS - 618
ER -