A randomized controlled trial of a diagnostic algorithm for symptoms of uncomplicated XXXX at an out-of-hours service.

@entity1 @entity2885 @entity2335
OBJECTIVE: To compare the clinical outcome of @entity1 presenting with symptoms of uncomplicated @entity2335 who were seen by a doctor, with @entity1 who were given treatment following a diagnostic algorithm. DESIGN: Randomized controlled trial. SETTING: Out-of-hours service, Oslo, Norway. INTERVENTION: @entity1 with typical symptoms of uncomplicated @entity2335 were included in the trial in the time period September 2010-November 2011. They were randomized into two groups. One group received standard treatment according to the diagnostic algorithm, the other group received treatment after a regular consultation by a doctor. SUBJECTS: @entity1 (n = 441) aged 16-55 years. Mean age in both groups 27 years. MAIN OUTCOME MEASURES: Number of days until symptomatic resolution. RESULTS: No significant differences were found between the groups in the basic @entity1 demographics, severity of symptoms, or percentage of urine samples with single culture growth. A median of three days until symptomatic resolution was found in both groups. By day four 79% in the algorithm group and 72% in the regular consultation group were free of symptoms (p = 0.09). The number of @entity1 who contacted a doctor again in the follow-up period and received alternative antibiotic treatment was insignificantly higher (p = 0.08) after regular consultation than after treatment according to the diagnostic algorithm. There were no cases of severe @entity2885 or hospital admissions during the follow-up period. CONCLUSION: Using a diagnostic algorithm is a safe and efficient method for treating @entity1 with symptoms of uncomplicated @entity2335 at an out-of-hours service. This simplification of treatment strategy can lead to a more rational use of consultation time and a stricter adherence to National Antibiotic Guidelines for a common disorder.
