Background Cystitis is one of the most common infections among women, affecting nearly 50% of them at least once in their lifetime. Despite its prevalence, diagnosis often relies on clinical symptoms and examination rather than microbiological confirmation, leading to potential diagnostic uncertainty and overuse of antibiotics. Objectives This study aimed to identify the clinical signs and symptoms used by general practitioners (GPs) in France to diagnose urinary tract infections (UTIs). Secondary objectives included assessing the impact of symptoms on daily activities, evaluating diagnostic certainty, and identifying factors that increase GP confidence. Methods The analysis was based on the ARIBO study, a multicentre, cluster‐randomised trial conducted in primary care in France. Eligible women presenting with symptoms of uncomplicated UTI completed a symptom questionnaire during their initial consultation. GPs recorded their diagnostic certainty, and patients completed the Activity Impairment Assessment (AIA) questionnaire at baseline, Day 5 and Day 14. Results A total of 36 GPs enrolled 162 women suspected of having a UTI. Five primary symptoms including burning or pain in urination , pollakiuria , hypogastric pain or heaviness , urinary urgency and feeling of bladder fullness were frequently reported. GPs reported high diagnostic certainty, with 93.1% rating their confidence as 4 or 5 on a 5‐point scale. Dipsticks were used in only 19.8% of cases. Conclusion GPs often rely on a small set of symptoms to diagnose cystitis and exhibit high confidence in their clinical diagnoses. Antibiotic prescription conditional on dipstick positivity in case of diagnostic doubt could improve antibiotic stewardship.
Dumont et al. (Thu,) studied this question.