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Current Challenges of UTI Management

watch Chris and Mandy discuss the current challenges of the management of UTI in primary care
Mandy I am really am hoping that we can convey the need for, really, a different way of thinking about this entirely. Call it a paradigm shift, if you like, or something grandiose like that. But let’s just imagine what’s happening now in primary care. So think Monday morning, think waiting room, winter time, chaos, phones going, babies screaming. And a call comes through. ‘I think I’ve got another water infection’. Receptionist might do one of three things; say ‘fine, I’ll get the doctor to leave out a prescription’. Probably wouldn’t happen in any of the practices that we relate to, but it could happen theoretically.
Or she could say, ‘well, I’ll get the doctor give you a call back at lunchtime’, or ‘come in for an appointment’, or something else. But what we found in our research, I think, was that 95% of those people contacting primary care with those symptoms, getting antibiotic.
But I think that that isn’t doing good enough for our patients. I think we could do a whole lot better, because what we also found is that only a quarter actually had a UTI on culture. That’s correct yeah. And there’s a lot of other things that could be going here. And so dysuria frequency equals antibiotics is yesterday’s thinking. We need a much more sophisticated approach about this, don’t we? Yeah, I agree. It’s not just the microbiology, it’s the prescribing as well. So get the diagnosis correct. If you’re going to prescribe an antibiotic, then get the right one. And then once you’ve prescribed the antibiotic, presumably the patient will get better quicker.
And that’s what we found with the poetic study, isn’t it? Yeah we did. Those who got antibiotics will get better quicker. But there’s a lot of women who will get better quicker, will get better in roughly the same amount of time, if you give them symptomatic treatment such as Ibuprofen, and that was shown in the recent trial in the BMJ.
Chris and Mandy discuss the current challenges of the management of UTI in primary care and introduce the real world presentation of patients and some of the current options available to healthcare professionals.
In the video Chris mentions an article that discusses a women’s journey with her UTI. 95% of women consulted a healthcare professional and 74% were prescribed antibiotics. To read more please follow this link.
Many women with urinary tract infection symptoms do not require antibiotics and in this study it was shown that two-thirds of women with UTI given Ibuprofen improved without antibiotics, however safety netting is important as complications were higher than those in the fosfomycin group.
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TARGET Antibiotics – Prescribing in Primary Care

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