The assessment and management of urinary tract infections in adults: Guidelines for pharmacists

Beahm, Nathan P; Nicolle, Lindsay E.; Bursey, Alistair; Smyth, Daniel; Tsuyuki, Ross T.

doi:10.1177/1715163517723036

Cited by 46 publications

(46 citation statements)

References 17 publications

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“…Uncomplicated urinary tract infections (UTIs) are common in women and are usually managed in primary care [ 1 , 2 ]. Primary care physicians mainly prescribe antibiotics [ 3 , 4 ], as recommended by most guidelines [ 5 – 7 ]. Symptomatic treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) is also recommended by several guidelines for women with mild to moderate symptoms [ 6 – 8 ].…”

Section: Introductionmentioning

confidence: 99%

Management of urinary tract infections: what do doctors recommend and patients do? An observational study in German primary care

et al. 2020

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Background Uncomplicated urinary tract infections (UTIs) in women are usually managed in primary care with antibiotics. However, many women seem to prefer to handle UTI symptoms with nonsteroidal anti-inflammatory drugs (NSAIDs) and other remedies. The aim of this study was to compare UTI management as recommended by physicians with the patients’ management at home. Methods This prospective cohort study in German primary care is based on clinical data from local practices and patient questionnaires. Participating women completed a baseline data sheet in the practice; their urine sample was tested by a dipstick in the practice and cultured by a laboratory. The women reported treatment and symptom-related impairment on an eight-item symptom questionnaire daily for 7 days. Using growth curve models, we analysed the influence of time on the total severity score to examine how symptoms changed across days. We then examined whether symptom severity and symptom course differed between patients who took antibiotics or NSAIDs. Results A total of 120 women (mean age of 43.3 ± 16.6 years) were enrolled. The urine dipstick was positive for leucocytes in 92%, erythrocytes in 87%, and nitrites in 23%. Physicians prescribed antibiotics for 102 (87%) women and recommended NSAIDs in 14 cases. According to the women’s reports, only 60% (72/120) took antibiotics, while the remainder took NSAIDs and other remedies. Symptoms declined from day 0 to day 6, irrespective of whether women decided to take an antibiotic, NSAIDs, none or both, as confirmed by a significant curvilinear time effect (B = 0.06, SE = 0.005, p < .001). The symptom course, however, was moderated by taking antibiotics so that the change in symptom severity was somewhat more pronounced in women taking antibiotics (B = 0.06) than in the remainder (B = 0.04). Conclusion A substantial proportion of women did not follow their physicians’ treatment recommendations, and many used NSAIDs. All women had a good chance of recovery irrespective of whether they decided to take antibiotics. A sensitive listening to patient preferences in the consultation may encourage physicians to recommend and prescribe symptomatic treatment with NSAID more often than antibiotic medicines.

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Section: Introductionmentioning

confidence: 99%

Management of urinary tract infections: what do doctors recommend and patients do? An observational study in German primary care

et al. 2020

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“…Also, as there are many modifiable risk factors for developing UTIs, it is important to effectively communicate these factors to patients to prevent recurrence and subsequent readmissions. As pharmacists already play a key role in medication counseling prior to hospital discharge, this presents an opportunity to incorporate patient education on infection management and prevention by pharmacists as part of ASPs [323][324][325].…”

Section: Recurrent Urinary Tract Infectionsmentioning

confidence: 99%

Clinical Pharmacists in Chronic Care

Mohiuddin¹

2019

GJMR

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Pharmacy practice has changed significantly lately. The professionals have the chance to contribute straightforwardly to patient consideration so as to lessen morbimortality identified with medication use, promoting wellbeing and preventing diseases. Healthcare organizations worldwide are under substantial pressure from increasing patient demand. Unfortunately, a cure is not always possible particularly in this era of chronic complications, and the role of physicians has become limited to controlling and palliating symptoms.The increasing population of patients with longterm conditions are associated with high levels of morbidity, healthcare costs and GP workloads. Clinical pharmacy took over an aspect of medical care that had been partially abandoned by physicians. Overburdened by patient loads and the explosion of new drugs, physicians turned to pharmacists more and more for drug information, especially within institutional settings. Once relegated to counting and pouring, pharmacists headed institutional reviews of drug utilization and served as consultants to all types of health-care facilities. In addition, when clinical pharmacists are active members of the care team, they enhance proficiency by: Providing critical input on medicine use and dosing. Working with patients to solve problems with their medications and improve compliance.

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“…Worldwide, UTI is one of the most common indications for antimicrobial prescriptions [5]. Due to the rarity of complications, uncomplicated lower UTIs are considered as benign and self-limiting, with the primary goal of achieving a fast symptomatic relief.…”

Section: Clinical Situation: a Normal Case Of Recurrent Cystitismentioning

confidence: 99%

UTI − quo vadis? New alternatives to treat uncomplicated urinary tract infections

et al. 2019

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Urinary tract infections (UTI) are one of the most common problems in urology clinics. The European Association of Urology (EAU) has been pioneering in its efforts to disseminate the latest clinical findings through the organization of the annual EAU congresses. At this year's congress (EAU Barcelona 2019), various satellite symposia were organized, focusing on specific issues in the field of urology. "UTI − quo vadis? New alternatives to treat uncomplicated urinary tract infections" was one of the industry-sponsored symposia, organized with the aim of evaluating the current scenario and also throwing light on the paradigm shift in the treatment of acute, uncomplicated lower urinary tract infections (uUTI). Several interlinking topics were presented during this symposium. The topics covered antibiotic resistance, involving a presentation of the current data from the Global Prevalence Study on Infections in Urology (GPIU-study). This discussion was followed by case reports on the impact of antibiotic resistance on the management of patients with UTI/uUTI and treatment options for UTI/uUTI according to current guidelines. The highlight of the symposium was the presentation of very recent data from a gold standard phase III clinical trial (double-blind, double-dummy randomized study), demonstrating the non-inferiority of a herbal medicine (BNO 1045) versus antibiotic therapy (fosfomycin trometamol (FT), as a single dose = 3 g) for the treatment of acute, uncomplicated cystitis.

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The assessment and management of urinary tract infections in adults: Guidelines for pharmacists

Abstract: C P J / R P C • S e p t e m b e r / O c t O b e r 2 0 1 7 • V O L 1 5 0 , N O 5

Cited by 46 publications

References 17 publications

Management of urinary tract infections: what do doctors recommend and patients do? An observational study in German primary care

Management of urinary tract infections: what do doctors recommend and patients do? An observational study in German primary care

Clinical Pharmacists in Chronic Care

UTI − quo vadis? New alternatives to treat uncomplicated urinary tract infections

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