P24S01: Urinary tract infection in breastfeeding woman

Bottom line: Information on urinary tract infection (UTI) was used to justify the management of a patient (use the right medication for lactating postpartum patient with UTI). It contributed to avoid inappropriate treatment.

Level 1 outcome (situational relevance): On December 31, 2008, P24 did a search at work, by themselves, and after an encounter with a patient. They retrieved one information hit on urinary tract infection (UTI). The reported search objectives were: to address a clinical question and, to look up something they had forgotten. “One of the nurses told me that basically she [the hospitalized patient, a postpartum woman in her thirties] wasn’t urinating. [...] So I had to basically look up an antibiotic to give her. It was after her delivery. [...] I went to see the patient. And I said “I’ll prescribe you antibiotics” and I didn’t tell her which one. I just went, I looked up [for information], and I went to see the nurses [for prescription and management]. [The clinical question was] what antibiotic to give for UTI [in this context]?.” According to P24, e-Therapeutics+ was the only source for information, and the found information was relevant.

Level 2 outcome (cognitive impact): One hit was associated with a report of positive cognitive impact (see table). Regarding practice improvement, P24 stated: “I’m a family doctor so I have a lot of occasions for that issue [UTI], [that is] very common, so it’s something that I will be using often.”

Retrieved information hit:

1)e-Therapeutics+ (CIRT): Therapeutics Tab – Keyword: UTI – Urinary tract infection –Table 3 (P24S01H01)

Level 3 outcome (information use): Information on urinary tract infection was retrieved, and used to justify the management of a patient (information used as presented in e-Therapeutics+). “[...] She [the patient] had an infection, so I had reasons to give her the antibiotics. [...] My concern [was] because she was lactating [...] and I didn’t know if the antibiotic I was gonna give her would have been good in her case. [...] I had to make sure that it was ok to give it for her.”

Level 4 outcome (patient health): Regarding patient health, P24 reported that the information contributed to avoid inappropriate treatment. “I didn’t want to give her the inappropriate [treatment] [...] because again she was lactating. [...] I picked up the medication and I gave it to the nurse. [...] I go to the patients every morning and she [the patient] wasn’t complaining anymore.”

Levels of outcome of information-seeking

Situational relevance	Positive cognitive impact	Information use	Patient health
Address a clinical question Look up something forgotten	Practice improved Reminded something Motivated to learn Confirmed Reassured	Justify choice	Avoid

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