Work Package 4: Evidence-based diagnosis and therapy of infections in human and veterinary medicine – University of Copenhagen

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Work Package 4: Evidence-based diagnosis and therapy of infections in human and veterinary medicine

Objective:

Inappropriate use of antibiotics has been highlighted as one of the most important causes for the development of antibiotics resistant strains. Therefore, taking a One Health approach, the WP4 group composed by medical doctors, veterinarians, and microbiologist will focus on initiatives to obtain evidence based knowledge about appropriate diagnosis and therapy of Urinary Tractinfections (UTIs), which is a common cause of consultation in humans and animals.

Main partners

  • Lars Bjerrum - Department of Public Health (IFSV) (WP leader)
  • Jens Peter Nielsen - Department of Large Animal Science (IVH)
  • Lisbeth Rem Jessen - Department of Veterinary Clinical and Animal Sciences (IKV)
  • Charlotte Reinhard Bjørnvad (IKV)
  • Luca Guardabassi - Department of Veterinary and Animal Sciences (IVH)

External collaborators:

  • Niels Frimodt-Møller - Rigshospitalet
  • Henrik TorkilWesth - Hvidovre Hospital
  • Robert Skov - Statens Seruminstitut
  • Ken Steen Pedersen - Pig research Center

Task 4.1. Mapping of current diagnostic and treatment practices in humans and animals withsuspected UTI

Representative samples will be collected by individual registration of patient/animal cases. We will perform a prospective clinical audit to obtain information on the diagnostic process, appropriateness of the treatment (prescription and choice of antibiotics) as well as prevalence and pattern of resistance strains.Furthermore, a questionnaire survey on urogenital infections in sow herds will be performed among representative veterinary pig practitioners.

Contact persons:
Gloria Cordoba (IFSV), Tina Møller Sørensen (IKVH), Lola Tolstrup Leihardt (IPH).

Task 4.2.Investigating clinical impact of Point of Care tests in humans and animals with suspected UTI

A randomized controlled trial will be performed in humans and animals to investigate the clinical impact of a combined culture and susceptibility test (Flexicult) on proper use of antibiotics. We hypothesize that flexicultenables the prescriber to tailor antibiotic prescriptionsand consequently optimizes treatment effectiveness and retarding the development of multi-drug antibiotic resistance.

Contact persons: Gloria Cordoba (IFSV), Anne Holm (IFSV,expected to start in 2014), Tina Møller Sørensen (IKVH), Lola Tolstrup Leihardt (IPH).

Task 4.3.Development of evidence-based diagnostic protocols for rational antibiotic use in human and animals with suspected UTI

Evidence-based clinical guidelines for the management of UTI in humans and animals will be developed based on the results from task 4.1 and 4.2 and a systematic review of best practices.

Contact persons: Gloria Cordoba (IFSV), Anne Holm (IFSV,expected to start in 2014), Tina Møller Sørensen (IKVH), Lola Tolstrup Leihardt (IPH).

Task 4.4. Interventions to obtain evidence-based treatment of UTIs

A cluster-randomised controlled trial will be performed to investigate change in clinical practice in a group of veterinarians and general practitioners exposed to the guidelines developed in task 4.3.

Contact persons: Anne Holm (IFSV,expected to start in 2014), Tina Møller Sørensen (IKVH).