Management of urinary tract infections in the community; clinical audit and patient survey

Fisher, Stacey Jayne, Graham, Clive, Kennard, James and Jonker, Leon ORCID logoORCID: (2023) Management of urinary tract infections in the community; clinical audit and patient survey. British Journal of General Practice Open (BJGP Open) . BJGPO.2022.0191.

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Background: Urinary tract infection (UTI) is a common ailment but can develop into sepsis. The outcomes related to UTI may potentially be affected by both patient and clinician management of UTI.

Aim: To explore the circumstances around a single UTI episode, to determine if there are patient and clinician related variables that may contribute to differences in management.

Design & setting: Survey and clinical audit in 12 General Practices in England.

Method: Patients, n=504, completed a bespoke survey and their corresponding index UTI consultation was audited . The TARGET (Treat Antibiotics Responsibly, Guidance, Education and Tools) UTI audit toolkit was utilised.

Results: Males self-manage their UTI symptoms – eg, increased fluid intake ( P <0.001, Chi-squared test) and analgesic s use ( P 0.036, Chi-squared test) – and indicate they lack UTI knowledge when compared to females ( P 0.002, Kruskal-Wallis test). Males also claimed to have waited significantly longer for a consultation appointment ( P 0.027, Chi-squared test). Antibiotics were prescribed in 98% of all cases, with adherence to clinical diagnostic guidelines lowest in females <65 years. Only 41% (89/221 of cases in this guideline sub-cohort) would have been a UTI - according to TARGET criteria - following a medical record audit.

Conclusion: UTI symptom management by clinicians is sub-optimal; (the lack of) symptoms are often insufficiently recorded in medical records. Additionally, suboptimal adhere to guidelines concerning urinalysis and microbiological investigation is common. Known increased clinical risks for males may be compounded by their more limited knowledge of (self)-managing UTI and their comparatively late presentation.

Item Type: Article
Journal / Publication Title: British Journal of General Practice Open (BJGP Open)
Publisher: Royal College of General Practitioners
ISSN: 2398-3795
Departments: Institute of Health > Medical Sciences
Additional Information: This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License (
Depositing User: Anna Lupton
Date Deposited: 04 Jul 2023 14:50
Last Modified: 04 Jul 2023 15:00


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