New study improves antibiotic prescribing for urinary tract infections in primary care

The University of Bristol's research helps GPs choose medications for UTIs.


The University of Bristol‘s research seeks to help GPs identify the optimal antibiotic for treating urinary tract infections (UTIs) and minimize antimicrobial resistance (AMR) through a five-year IPAP (Improving Primary Care Antibiotic Prescribing) UTI program.

The NHS treats UTIs as the most prevalent bacterial illness, with antibiotic resistance rates as high as 50%. Working with NHS and UK Health Security Agency partners, the researchers will create a behavior change intervention to encourage physicians to prioritize various first-choice antibiotics and analyze the impact on AMR.

The National Institute for Health and Clinical Excellence (NICE) has advised general practitioners and nurses to administer nitrofurantoin instead of trimethoprim. Both recommended first-line antibiotics for treating urinary tract infections. According to some research, this has lowered trimethoprim AMR rates in some locations but not all and may have resulted in more excellent AMR rates for other antibiotics.

Randomized controlled trials (RCTs) are often regarded as the sole trustworthy approach for determining the efficacy of medications. The plan will involve three randomized controlled trials (RCTs) in locations with specific AMR challenges, including groups most hit by resistant UTIs. Some GP practices will be urged to adopt the alternative first-choice antibiotic. However, others will continue to use their standard antibiotic.

Alastair Hay, a GP and Professor of Primary Care at CAPC, and Senior Programme Co-Lead, added: “The robust design of our research program and our commitment to ensuring local area and population differences are taken into account means that we are confident that our program will deliver reliable results that can be used to guide both policy and practice in the UK.”

According to Dr. Ashley Hammond, AMR is a critical threat to people’s health, Research Fellow in Infectious Disease Epidemiology at CAPC Programme Lead, and treating it might result in considerable advantages for individuals, the NHS, and public health.

According to Professor Susan Hopkins, Chief Medical Advisor of the UK Health Security Agency, monitoring prescribing trends for these illnesses and performing community trials can help drive down resistance and provide patients with the right therapy at the right time.

According to Elizabeth Beech MBE, NHS England Regional Antimicrobial Stewardship Lead, UTIs are widespread, especially in women, who frequently have UTI more than once, raising the risk of antibiotic resistance.

She said: “Urinary tract infections are prevalent, particularly in women who often experience UTI more than once, increasing the risk of antibiotic-resistant infection. Ensuring UTI can be successfully treated quickly really matters. This research will increase our understanding of how to do this in clinical practice.”

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