Effectiveness and safety of telemedical management in uncomplicated urinary tract infections.

Uncomplicated urinary tract infections (UUTI) in women are frequent reasons for consultations in general practice. We evaluated the effectiveness and safety of telemedical management at a telemedicine centre in Switzerland. Management followed evidence-based protocols, including teleprescription of an antibiotic. Consecutive UUTI patients who had a teleconsultation including the prescription of an antibiotic were followed up three days later about symptom relief, adverse events or the need to visit a doctor. Of a total of 526 eligible women, follow-up information was available for 95%. Three days after teleconsultation, 79% of patients reported complete symptom relief, and 92% reported a reduction of UUTI symptoms. Five percent of patients reported deterioration, e.g. due to an increase of pain, flank pain or fever. Four percent reported side-effects of the prescribed antibiotics. In the three days following teleconsultation, 4% of women consulted another health-care provider without further contacting the telemedicine centre. Another 8% of patients were referred to face-to-face consultation because they developed additional symptoms or because bacterial resistance of the prescribed antibiotic was suspected. Compared to data from the literature on UUTI, evidence-based telemedical management including teleprescription of an antibiotic is as safe and effective as prescriptions initiated by a face-to-face consultation.