Medians for nine quality indicators (QI) and accompanying standards focusing on the treatment decision for urinary tract infections (UTI)
| Rationale behind I | Definition of QI (numerator:denominator) | Standards (%) | Median, range 1–9 |
| Patients with suspected UTI | |||
| QIA: No antibiotics without specific symptoms | Patients* without symptoms†‡ who had a positive urinary dipstick (nitrite and leucocytes) and/or a positive microscopy treated with antibiotics: patients* without symptoms†‡ who had a positive urinary dipstick (nitrite and leucocytes) and/or a positive microscopy | 0–10 | 9 |
| Patients with lower UTI | |||
| QI12: No antibiotics without urinalysis | Patients§ not examined with urinary dipstick or microscopy treated with antibiotics: Patients§ not examined with urinary dipstick or microscopy | 0–10 | 9¶ |
| QIB: Antibiotics for patients with high probability of UTI | Patients§ with ≥1 symptom† and a positive urinary dipstick (nitrite and leucocytes) and/or a positive microscopy treated with antibiotics: patients§ with ≥1 symptom† and a positive urinary dipstick (nitrite and leucocytes) and/or a positive microscopy | 90–100 | 7 |
| QI13: No antibiotics for patients with low probability of bacteriuria | Patients§ with ≥1 symptom† and a negative urinary dipstick (nitrite and leucocytes) treated with antibiotics: Patients§ with ≥1 symptom† and a negative urinary dipstick (nitrite and leucocytes) | 0–10 | 9¶ |
| QI14: Wait with antibiotics when inconclusive urinary dipstick | Patients§ with ≥1 symptom† and a urinary dipstick with positive leucocytes but negative nitrite treated with antibiotics: patients§ with ≥1 symptom† and a urinary dipstick with positive leucocytes but negative nitrite | 0–20 | 9¶ |
| Patients with pyelonephritis | |||
| QI15: Antibiotics for patients with pyelonephritis | Patients** treated with antibiotics: patients** | 90–100 | 9¶ |
| Patients with catheter and UTI | |||
| QI16: Antibiotics for catheter users with UTI | Patients†† with ≥1 symptom‡ treated with antibiotics: patients†† with ≥1 symptom‡ | 90–100 | 9¶ |
| QI17: Change of catheter for catheter users with UTI | Patients†† with ≥1 symptom‡ and change of catheter: patients†† with ≥1 symptom‡ | 90–100 | 9¶ |
| Patients with pregnancy and UTI | |||
| QI18: No antibiotics for pregnant women without urinalysis | Patients‡‡ not examined with urinary dipstick or microscopy treated with antibiotics: patients‡‡ not examined with urinary dipstick or microscopy | 0–10 | 9¶ |
Catheter: Chronic indwelling urethral or suprapubic catheter.
Unresolved: Continued suspicion of UTI, but, for example, awaiting a urine culture result.
*Patients with suspected UTI (the diagnosis: ‘complicated lower UTI’, ‘uncomplicated lower UTI’, ‘pyelonephritis’ and ‘unresolved’).
†Symptoms of lower UTI: dysuria, frequency, urgency, new-onset incontinence, suprapubic pain.
‡Symptoms of pyelonephritis: fever, shivering, flank pain, systemically unwell.
§Patients with suspected lower UTI (the diagnosis: ‘complicated lower UTI’, ‘uncomplicated lower UTI’ and ‘unresolved’).
¶Consensus of appropriateness after second round.
**Patients diagnosed with pyelonephritis (the diagnosis: ‘pyelonephritis’) excluding patients referred to hospital.
††Catheter users with suspected UTI (the diagnosis: ‘complicated lower UTI’, ‘uncomplicated lower UTI’, ‘pyelonephritis’ and ‘unresolved’) excluding patients referred to hospital.
‡‡Pregnant women with suspected UTI (the diagnosis: ‘complicated lower UTI’, ‘uncomplicated lower UTI’, ‘pyelonephritis’ and ‘unresolved’).