Introduction to Prescribing in UTI

Good day I’m Chris Butler. I’m a GP, but mainly a researcher and one of my research interests is in urinary tract infection. I’ve done some interesting studies with Mandy Wootton. Hi I’m Dr Mandy Wootton. I’m a lead scientist at University Hospital in Wales and I too do clinical trial work with Chris, particularly on UTIs. So Mandy and I are really excited about talking today about urinary tract infection. We’ve done a lot of research together. I’m a sort of a part time GP so at least I breathe the air in real general practice occasionally.

But we’ve done some exciting studies about the management, presentation, and outcome of and microbiology of urinary tract infection in primary care, and we want to share some of the important points that has come out of this research, and other bits of research that might help improve the management of urinary tract infection. Not only the management, but I think our conceptual framework of thinking about it. Mmmm, I agree In particular, focusing on microbiology. What percentage of urine is positive for an infection? Because we found it was quite low. Yeah, we were surprised by that. And also what prescribing, as well as the diagnosis.

But I think in that poetic study that we were talking about, I think we found, certainly in England and Wales, that the vast majority of prescribing was for Trimethoprim in Wales and split between Trimethoprim and Nitrofurantoin in England in the English sites, which is kind of good news, isn’t it? Yeah, because Trimethoprim, for a long time, has been a first line choice for UTIs. Unfortunately though, E. coli resistance to Trimethoprim is around 35% now, which is quite high. When you compare that to Nitrofurantoin, which is around 3%, then you can see there may be a problem with actually, if it’s going to treat your UTI successfully.