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Ann Intern Med. 2001 Jul 3;135(1):9-16.

Patient-initiated treatment of uncomplicated recurrent urinary tract infections in young women.

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1
Department of Medicine/Division of Allergy and Infectious Diseases, 1959 NE Pacific Street, Box 356523, University of Washington, Seattle, WA 98195, USA.

Abstract

BACKGROUND:

Recurrent urinary tract infections (UTIs) are a common outpatient problem, resulting in frequent office visits and often requiring the use of prophylactic antimicrobial agents. Patient-initiated treatment of recurrent UTIs may decrease antimicrobial use and improve patient convenience.

OBJECTIVE:

To determine the safety and feasibility of patient-initiated treatment of recurrent UTIs.

DESIGN:

Uncontrolled, prospective clinical trial.

SETTING:

University-based primary health care clinic.

PARTICIPANTS:

Women at least 18 years of age with a history of recurrent UTIs and no recent pregnancy, hypertension, diabetes, or renal disease.

INTERVENTION:

After self-diagnosing UTI on the basis of symptoms, participating women initiated therapy with ofloxacin or levofloxacin.

MEASUREMENTS:

Accuracy of self-diagnosis determined by evidence of a definite (culture-positive) or probable (sterile pyuria and no alternative diagnosis) UTI on pretherapy urinalysis and culture. Women with a self-diagnosis of UTI that was not microbiologically confirmed were evaluated for alternative diagnoses. Post-therapy interviews and urine cultures were used to assess clinical and microbiological cure rates, adverse events, and patient satisfaction.

RESULTS:

88 of 172 women self-diagnosed a total of 172 UTIs. Laboratory evaluation showed a uropathogen in 144 cases (84%), sterile pyuria in 19 cases (11%), and no pyuria or bacteriuria in 9 cases (5%). Clinical and microbiological cures occurred in 92% and 96%, respectively, of culture-confirmed episodes. No serious adverse events occurred.

CONCLUSION:

Adherent women can accurately self-diagnose and self-treat recurrent UTIs.

PMID:
11434727
[Indexed for MEDLINE]
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