TY - JOUR
T1 - Patient-initiated treatment of uncomplicated recurrent urinary tract infections in young women
AU - Gupta, K.
AU - Hooton, T. M.
AU - Roberts, P. L.
AU - Stamm, W. E.
N1 - Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2001/7/3
Y1 - 2001/7/3
N2 - 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.
AB - 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.
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U2 - 10.7326/0003-4819-135-1-200107030-00004
DO - 10.7326/0003-4819-135-1-200107030-00004
M3 - Article
C2 - 11434727
AN - SCOPUS:0035800050
VL - 135
SP - 9
EP - 16
JO - Annals of Internal Medicine
JF - Annals of Internal Medicine
SN - 0003-4819
IS - 1
ER -