Uncomplicated urinary tract infection (UTI)
UNCOMPLICATED URINARY
TRACT INFECTION (UTI)
ELIGIBILITY:1 For women aged 16 to 64 years with suspected lower UTIs
EXCLUDE: Pregnant individuals, urinary catheter, recurrent UTI (2 episodes in last 6 months, or 3 episodes in last 12 months)
A LOWER URINARY TRACT INFECTION (UTI) is an infection of the bladder (also known as cystitis), usually caused by bacteria entering the urethra. Women suffering with moderate to severe symptoms of an uncomplicated UTI may be offered antibiotics.1 ‘Complicated’ UTIs refer to an infection associated with other difficulties, particularly when the bacteria travels up the tract and affects the kidneys, causing an upper UTI.8,9
66-year-old Janet approaches the counter with some cystitis relief sachets. She wonders if she can be referred to the Pharmacy First service as she thinks she has a UTI.
You recognise that her age means that she is not eligible for the service,1 however it is important to offer her the best advice and recommendations. It is also important to rule out another type of vaginal infection, such as thrush or bacterial vaginosis (BV).
Pain or a burning sensation when urinating
Needing to urinate more frequently
Needing to urinate more frequently at night
Needing to urinate suddenly or more urgently than usual
Cloudy urine
Janet’s symptoms indicate a UTI.
Blood present in urine
Confused or drowsy
Lower tummy pain
Pain in the back, just under the ribs
Fever, or feeling hot and shivery
A very low temperature below 36°C
These symptoms could indicate a kidney infection, which can be serious if left untreated as it can lead to sepsis.
Click the button to find out whether this customer is eligible for referral.
REFERRAL OUTCOME
NOT referred to the Pharmacy First service
Although Janet does have appear to have a UTI, her red flags indicate that her infection could be ‘complicated’, and she should ask for an urgent GP appointment.8 You tell Janet:
"You do appear to have a UTI; however, you are unfortunately not eligible for the Pharmacy First service. The symptoms you have described require an urgent appointment with your GP so that they can assess you further and ensure that you receive the treatment that you need."
Janet agrees as she has had infections in the past that have cleared on their own, but this one seems slightly worse. She asks if there is anything she can do to prevent it happening again and something she can take to help relieve her symptoms until she gets an appointment with her GP.
PREVENTION TIPS
DO:
Wipe from front to back when going to the toilet
Keep the genital area clean and dry
Drink plenty of fluids, particularly water, to regulate urination and avoid dehydration
Wash the skin around the vagina with water before and after sex
Urinate as soon as possible after sex
DON’T:
Use scented soap in your intimate area
Delay urinating when you feel the urge to go
Rush when urinating, try to fully empty the bladder
Wear tight synthetic underwear, such as nylon
Drink large quantities of alcohol
Consume lots of sugary drinks and foods – they can encourage the growth of bacteria
SELF-CARE ADVICE & PRODUCT RECOMMENDATIONS
For symptom relief until she sees her GP, she can:8
Take paracetamol to help with the pain and fever
Avoid sex
Make sure she rests and drinks plenty of fluids so that she can pass urine regularly during the day
Some people take cystitis sachets or cranberry drinks and products every day to prevent UTIs from happening, which may help.
Complete the care
Janet buys some paracetamol and thanks you for your help and advice. She tells you that she is heading to her GP surgery now to seek an urgent appointment. You advise her to come back if she needs any further advice.
KEY LEARNING POINT
People who are excluded from the service may be more liable to complications and sometimes require additional assessment and monitoring. It’s important to refer those who aren’t eligible to an appropriate setting, e.g. GP or walk in centre, so that they can receive the best possible care without delay.