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Background: Research on acute cystitis in men is scarce and treatment guidelines differ between countries. Improved antibiotic stewardship is needed. Aim: To analyse antibiotic prescriptions and outcomes of Norwegian men diagnosed with cystitis in primary care. Design & setting: A nationwide retrospective study was undertaken in primary care in Norway. Method: We identified all episodes of acute cystitis in men diagnosed in Norwegian primary care during 2012–2019. Choice of antibiotic (from the Norwegian Prescription Database), treatment failure, re-prescription, and complications were stratified by age, calendar year, and risk factors. We used logistic regression to explore predefined risk factors (diabetes, prostate cancer, benign prostate hyperplasia [BPH], urinary retention, and any cancer) with complications (pyelonephritis, prostatitis, and hospitalisation) and re-prescriptions. Linear regression was used to explore time trends. Results: In total, 108 994 individuals contributed 148 635 episodes. Narrow-spectrum antibiotics were first-choice treatment in 71.0% of the episodes (52.5% of all prescriptions were pivmecillinam). More than 75% of the episodes with narrow-spectrum versus 82.2% of broad-spectrum treatment did not lead to any re-prescription or complication. Complications occurred in 1.8% of all episodes (0.5% prostatitis, 0.7% pyelonephritis, and 0.7% hospitalisation). BPH was associated with increased risk of complications and re-prescription. Diabetes was associated with a lower risk of re-prescriptions. Prostate cancer and urinary retention were associated with a lower risk of both complications and re-prescriptions. Conclusion: Our results support narrow-spectrum antibiotics as first-line treatment. Risk factor analyses warrants further investigation. [ABSTRACT FROM AUTHOR]

Most action researchers agree that action research consists of cycles of planning, acting, reflecting, and taking further action. However, in action research literature, there is something missing. The nature of reflection in the action research process, including its relationship with the tensions that arise while discussing purposes, processes, and outcomes, has not been well explored. As a contribution to an expanded reflection repertoire, this article presents a thinking tool: the expansive learning circle. This model, or thinking tool, draws on the theoretical framework of cultural–historical activity theory and the idea that contradictions and tensions are driving forces for development. The central thesis of the article is that there is a need for a reflection repertoire that can highlight tension in an action research project and help people cope with this type of complex reflective work. [ABSTRACT FROM AUTHOR]