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Clin Infect Dis. 2004 Apr 15;38 Suppl 3:S203-11.

Survey of physician diagnostic practices for patients with acute diarrhea: clinical and public health implications.

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Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.


To understand physician practices regarding the diagnosis of acute diarrheal diseases, we conducted a survey, in 1996, of 2839 physicians in Connecticut, Georgia, Minnesota, Oregon, and California. Bacterial stool culture was requested for samples from the last patient seen for acute diarrhea by 784 (44%; 95% confidence interval, 42%-46%) of 1783 physicians. Physicians were more likely to request a culture for persons with acquired immune deficiency syndrome, bloody stools, travel to a developing country, diarrhea for >3 days, intravenous rehydration, or fever. Substantial geographic and specialty differences in culture-request practices were observed. Twenty-eight percent of physicians did not know whether stool culture included testing for Escherichia coli O157:H7; 40% did not know whether Yersinia or Vibrio species were included. These variabilities suggest a need for clinical diagnostic guidelines for diarrhea. Many physicians could benefit from education to improve their knowledge about tests included in routine stool examinations.

[Indexed for MEDLINE]

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