Gágyor, Ildikó

[["dc.bibliographiccitation.firstpage","E234"],["dc.bibliographiccitation.issue","645"],["dc.bibliographiccitation.journal","British Journal of General Practice"],["dc.bibliographiccitation.lastpage","E240"],["dc.bibliographiccitation.volume","66"],["dc.contributor.author","Gágyor, Ildikó"],["dc.contributor.author","Haasenritter, Jörg"],["dc.contributor.author","Bleidorn, Jutta"],["dc.contributor.author","McIsaac, Warren"],["dc.contributor.author","Schmiemann, Guido"],["dc.contributor.author","Hummers-Pradier, Eva"],["dc.contributor.author","Himmel, Wolfgang"],["dc.date.accessioned","2020-12-10T18:47:26Z"],["dc.date.available","2020-12-10T18:47:26Z"],["dc.date.issued","2016"],["dc.description.abstract","Background Uncomplicated urinary tract infection (UTI) is often treated with antibiotics, resulting in increasing resistance levels. A randomised controlled trial showed that two-thirds of females with UTI treated symptomatically recovered without subsequent antibiotic treatment. Aim To investigate whether there are differences between females with a UTI who were subsequently prescribed antibiotics and those who recovered with symptomatic treatment only, and to develop a model to predict those who can safely and effectively be treated symptomatically. Design and setting This is a subgroup analysis of females assigned to ibuprofen in a UTI trial in general practices. Method Multiple logistic regression analysis was used to select variables for a prediction model, The discriminative value of the model was estimated by the area under the receiver operator curve (AUC) and the effects of different thresholds were calculated within the model predicting antibiotic prescription and need for follow-up visits. Results Of the 235 females in the ibuprofen group, 79 were subsequently prescribed antibiotics within 28 days of follow-up. The final model included five predictors: urgency/frequency, impaired daily activities, and positive dipstick test results for erythrocytes, leucocytes, and nitrite. The AUC was 0.73 (95% CI = 0.67 to 0.80). A reasonable threshold for antibiotic initiation would result in 58% of females presenting with UTI being treated with antibiotics. Of the remaining females, only 6% would return to the practice because of symptomatic treatment failure. Conclusion The present model revealed moderately good accuracy and could be the basis for a decision aid for GPs and females to find the treatment option that fits best."],["dc.identifier.doi","10.3399/bjgp16X684361"],["dc.identifier.isi","000376585200002"],["dc.identifier.pmid","26965031"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/14110"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/78763"],["dc.language.iso","en"],["dc.notes.intern","DOI Import GROB-354"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.relation.issn","1478-5242"],["dc.relation.issn","0960-1643"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.rights","CC BY-NC 3.0"],["dc.rights.uri","https://creativecommons.org/licenses/by-nc/3.0"],["dc.title","Predicting antibiotic prescription after symptomatic treatment for urinary tract infection: development of a model using data from an RCT in general practice"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","38"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","Research Involvement and Engagement"],["dc.bibliographiccitation.volume","5"],["dc.contributor.author","Schilling, Imke"],["dc.contributor.author","Behrens, Heike"],["dc.contributor.author","Bleidorn, Jutta"],["dc.contributor.author","Gágyor, Ildikó"],["dc.contributor.author","Hugenschmidt, Claudia"],["dc.contributor.author","Jilani, Hannah"],["dc.contributor.author","Schmiemann, Guido"],["dc.contributor.author","Gerhardus, Ansgar"],["dc.date.accessioned","2019-12-01T04:26:32Z"],["dc.date.accessioned","2021-10-27T13:21:39Z"],["dc.date.available","2019-12-01T04:26:32Z"],["dc.date.available","2021-10-27T13:21:39Z"],["dc.date.issued","2019"],["dc.date.updated","2019-12-01T04:26:32Z"],["dc.description.abstract","Background Patient and public involvement (PPI) has become an essential part of the design, conduct, and dissemination of research. While researchers who employed PPI mainly report on the positive aspects, in practice PPI is still an exception in clinical trials in Germany. There are specific challenges in the process of involvement that can jeopardize the conduct of involvement. The aim of our study was to analyze the experience of patients and researchers with PPI in a clinical trial in Germany, so we could learn more about potential challenges and how they could be addressed. Methods We established a patient board for a randomized controlled trial on urinary tract infections, where patients and researchers regularly met to discuss relevant aspects of the trial. Minutes were taken for each meeting and the moderator also noted her observations in a postscript. After four meetings, we conducted two focus groups, one each with the patients and researchers. We analyzed and categorized the minutes, postscripts, and focus group transcripts using thematic qualitative text analysis. Results Patients and researchers felt comfortable with the composition of the patient board and its’ atmosphere. In terms of challenges, patients and researchers needed time to get familiar with PPI. Both parties saw a need for training in PPI but differed in their views on the relevant topics. Patients wished to learn more about their role and tasks within the board at the onset of the PPI. They also preferred to meet more frequently and get more intensely involved in the trial. In contrast, researchers perceived that they were already highly involved. They further felt that the involvement was of benefit to them, the trial and future research. Patients described benefits for themselves, but also wondered if their involvement had had an impact on the trial. Conclusions To facilitate effective PPI, resources, adequate structures, and training are needed. Patients and researchers need to agree on their respective roles, training needs, and the mode of cooperation right at the beginning. The parties involved should continuously reflect on the actual benefits of PPI, describe them explicitly and make them transparent for all."],["dc.identifier.doi","10.1186/s40900-019-0172-0"],["dc.identifier.pmid","31798964"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/16761"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/92038"],["dc.language.iso","en"],["dc.notes.intern","Migrated from goescholar"],["dc.relation.orgunit","Universitätsmedizin Göttingen"],["dc.rights","CC0 1.0 Universal"],["dc.rights.holder","The Author(s)."],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.title","Patients’ and researchers’ experiences with a patient board for a clinical trial on urinary tract infections"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","33"],["dc.bibliographiccitation.journal","BMC Urology"],["dc.bibliographiccitation.volume","12"],["dc.contributor.author","Schmiemann, Guido"],["dc.contributor.author","Gágyor, Ildikó"],["dc.contributor.author","Hummers-Pradier, Eva"],["dc.contributor.author","Bleidorn, Jutta"],["dc.date.accessioned","2018-11-07T09:03:17Z"],["dc.date.available","2018-11-07T09:03:17Z"],["dc.date.issued","2012"],["dc.description.abstract","Background: Guideline recommendations on therapy in urinary tract infections are based on antibiotic resistance rates. Due to a lack of surveillance data, little is known about resistance rates in uncomplicated urinary tract infection (UTI) in general practice in Germany. In a prospective observational study, urine cultures of all women presenting with urinary tract infections in general practice were analysed. Resistance rates against antibiotics recommended in German guidelines on UTI are presented. Methods: In a prospective, multi-center observational study general practitioner included all female patients >= 18 years with clinically suspected urinary tract infection. Only patients receiving an antibiotic therapy within the last two weeks were excluded. Results: 40 practices recruited 191 female patients (mean age 52 years; range 18-96) with urinary tract infections. Main causative agent was Escherichia coli (79%) followed by Enterococcus faecalis (14%) and Klebsiella pneumoniae (7.3%). Susceptibiliy of E. coli as the main causative agent was highest against fosfomycin and nitrofurantoin, with low resistance rates of 4,5%; 2,2%. In 17,5%, E. coli was resistant to trimethoprim and in 8,5% to ciprofloxacin. Conclusions: Resistance rates of uropathogens from unselected patients in general practice differ from routinely collected laboratory data. These results can have an impact on antibiotic prescribing and treatment recommendations."],["dc.identifier.doi","10.1186/1471-2490-12-33"],["dc.identifier.isi","000313245000001"],["dc.identifier.pmid","23171154"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/8468"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/24875"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.relation.issn","1471-2490"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.rights","CC BY 2.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/2.0"],["dc.title","Resistance profiles of urinary tract infections in general practice - an observational study"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","203"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","BMC Complementary and Alternative Medicine"],["dc.bibliographiccitation.volume","18"],["dc.contributor.author","Afshar, Kambiz"],["dc.contributor.author","Fleischmann, Nina"],["dc.contributor.author","Schmiemann, Guido"],["dc.contributor.author","Bleidorn, Jutta"],["dc.contributor.author","Hummers-Pradier, Eva"],["dc.contributor.author","Friede, Tim"],["dc.contributor.author","Wegscheider, Karl"],["dc.contributor.author","Moore, Michael"],["dc.contributor.author","Gágyor, Ildikó"],["dc.date.accessioned","2019-07-09T11:45:32Z"],["dc.date.available","2019-07-09T11:45:32Z"],["dc.date.issued","2018"],["dc.description.abstract","BACKGROUND: Uncomplicated urinary tract infections (UTI) are common in general practice and usually treated with antibiotics. This contributes to increasing resistance rates of uropathogenic bacteria. A previous trial showed a reduction of antibiotic use in women with UTI by initial symptomatic treatment with ibuprofen. However, this treatment strategy is not suitable for all women equally. Arctostaphylos uva-ursi (UU, bearberry extract arbutin) is a potential alternative treatment. This study aims at investigating whether an initial treatment with UU in women with UTI can reduce antibiotic use without significantly increasing the symptom burden or rate of complications. METHODS: This is a double-blind, randomized, and controlled comparative effectiveness trial. Women between 18 and 75 years with suspected UTI and at least two of the symptoms dysuria, urgency, frequency or lower abdominal pain will be assessed for eligibility in general practice and enrolled into the trial. Participants will receive either a defined daily dose of 3 × 2 arbutin 105 mg for 5 days (intervention) or fosfomycin 3 g once (control). Antibiotic therapy will be provided in the intervention group only if needed, i.e. for women with worsening or persistent symptoms. Two co-primary outcomes are the number of all antibiotic courses regardless of the medical indication from day 0-28, and the symptom burden, defined as a weighted sum of the daily total symptom scores from day 0-7. The trial result is considered positive if superiority of initial treatment with UU is demonstrated with reference to the co-primary outcome number of antibiotic courses and non-inferiority of initial treatment with UU with reference to the co-primary outcome symptom burden. DISCUSSION: The trial's aim is to investigate whether initial treatment with UU is a safe and effective alternative treatment strategy in women with UTI. In that case, the results might change the existing treatment strategy in general practice by promoting delayed prescription of antibiotics and a reduction of antibiotic use in primary care."],["dc.identifier.doi","10.1186/s12906-018-2266-x"],["dc.identifier.pmid","29970072"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/15242"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/59254"],["dc.language.iso","en"],["dc.notes.intern","Merged from goescholar"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.relation.orgunit","Institut für Medizinische Statistik"],["dc.rights","CC BY 4.0"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.title","Reducing antibiotic use for uncomplicated urinary tract infection in general practice by treatment with uva-ursi (REGATTA) – a double-blind, randomized, controlled comparative effectiveness trial"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","h6544"],["dc.bibliographiccitation.journal","The BMJ"],["dc.bibliographiccitation.volume","351"],["dc.contributor.author","Gágyor, Ildikó"],["dc.contributor.author","Bleidorn, Jutta"],["dc.contributor.author","Kochen, Michael M."],["dc.contributor.author","Schmiemann, Guido"],["dc.contributor.author","Wegscheider, Karl"],["dc.contributor.author","Hummers-Pradier, Eva"],["dc.date.accessioned","2019-07-10T08:11:57Z"],["dc.date.available","2019-07-10T08:11:57Z"],["dc.date.issued","2015"],["dc.description.abstract","STUDY QUESTION:  Can treatment of the symptoms of uncomplicated urinary tract infection (UTI) with ibuprofen reduce the rate of antibiotic prescriptions without a significant increase in symptoms, recurrences, or complications? METHODS:  Women aged 18-65 with typical symptoms of UTI and without risk factors or complications were recruited in 42 German general practices and randomly assigned to treatment with a single dose of fosfomycin 3 g (n=246; 243 analysed) or ibuprofen 3×400 mg (n=248; 241 analysed) for three days (and the respective placebo dummies in both groups). In both groups additional antibiotic treatment was subsequently prescribed as necessary for persistent, worsening, or recurrent symptoms. The primary endpoints were the number of all courses of antibiotic treatment on days 0-28 (for UTI or other conditions) and burden of symptoms on days 0-7. The symptom score included dysuria, frequency/urgency, and low abdominal pain. STUDY ANSWER AND LIMITATIONS:  The 248 women in the ibuprofen group received significantly fewer course of antibiotics, had a significantly higher total burden of symptoms, and more had pyelonephritis. Four serious adverse events occurred that lead to hospital referrals; one of these was potentially related to the trial drug. Results have to be interpreted carefully as they might apply to women with mild to moderate symptoms rather than to all those with an uncomplicated UTI. WHAT THIS PAPER ADDS:  Two thirds of women with uncomplicated UTI treated symptomatically with ibuprofen recovered without any antibiotics. Initial symptomatic treatment is a possible approach to be discussed with women willing to avoid immediate antibiotics and to accept a somewhat higher burden of symptoms. FUNDING, COMPETING INTERESTS, DATA SHARING:  German Federal Ministry of Education and Research (BMBF) No 01KG1105. Patient level data are available from the corresponding author. Patient consent was not obtained but the data are anonymised and risk of identification is low.Trial registration No ClinicalTrialGov Identifier NCT01488955."],["dc.identifier.doi","10.1136/bmj.h6544"],["dc.identifier.pmid","26698878"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/12756"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/60828"],["dc.language.iso","en"],["dc.relation.issn","1756-1833"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.rights","CC BY-NC 3.0"],["dc.rights.uri","https://creativecommons.org/licenses/by-nc/3.0"],["dc.title","Ibuprofen versus fosfomycin for uncomplicated urinary tract infection in women: randomised controlled trial"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","146"],["dc.bibliographiccitation.journal","BMC Infectious Diseases"],["dc.bibliographiccitation.volume","12"],["dc.contributor.author","Gágyor, Ildikó"],["dc.contributor.author","Hummers-Pradier, Eva"],["dc.contributor.author","Kochen, Michael M."],["dc.contributor.author","Schmiemann, Guido"],["dc.contributor.author","Wegscheider, Karl"],["dc.contributor.author","Bleidorn, Jutta"],["dc.date.accessioned","2018-11-07T09:09:09Z"],["dc.date.available","2018-11-07T09:09:09Z"],["dc.date.issued","2012"],["dc.description.abstract","Background: Uncomplicated urinary tract infections (UTI) are usually treated with antibiotics as recommended by primary care guidelines. Antibiotic treatment supports clinical cure in individual patients but also leads to emerging resistance rates in the population. We designed a comparative effectiveness study to investigate whether the use of antibiotics for uncomplicated UTI could be reduced by initial treatment with ibuprofen, reserving antibiotic treatment to patients who return due to ongoing or recurrent symptoms. Methods/design: This is a randomized-controlled, double-blind, double dummy multicentre trial assessing the comparative effectiveness of immediate vs. conditional antibiotic therapy in uncomplicated UTI. Women > 18 and < 65 years, presenting at general practices with at least one of the typical symptoms dysuria or frequency/urgency of micturition, will be screened and enrolled into the trial. During an 18-months recruitment period, a total of 494 patients will have to be recruited in 45 general practices in Lower Saxony. Participating patients receive either immediate antibiotic therapy with fosfomycin-trometamol 1x3g or initial symptomatic treatment with ibuprofen 3x400mg for 3 days. The ibuprofen group will be provided with antibiotic therapy only if needed, i.e. for persistent or worsening symptoms. For a combined primary endpoint, we choose the number of all antibiotic prescriptions regardless of the medical indication day 0-28 and the \"disease burden\", defined as a weighted sum of the daily total symptom scores from day 0 to day 7. The study is considered positive if superiority of conditional antibiotic treatment with respect to the first primary endpoint and non-inferiority of conditional antibiotic treatment with respect to the second primary endpoint is proven. Discussion: This study aims at investigating whether the use of antibiotics for uncomplicated UTI could be reduced by initial treatment with ibuprofen. The comparative effectiveness design was chosen to prove the effectiveness of two therapeutic strategies instead of the pure drug efficacy."],["dc.description.sponsorship","Open-Access-Publikationsfonds 2012"],["dc.identifier.doi","10.1186/1471-2334-12-146"],["dc.identifier.isi","000307225600001"],["dc.identifier.pmid","22742538"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/7849"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/26192"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.relation.issn","1471-2334"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.rights","CC BY 2.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/2.0"],["dc.title","Immediate versus conditional treatment of uncomplicated urinary tract infection - a randomized-controlled comparative effectiveness study in general practices"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]