A new guide for clinicians on how to prescribe against and treat UTIs has been published in JAMA Network Open.
Telehealth services that prescribe antibiotics at more rapid rates speed up UTI care, but they also “raise the risk of overusing antibiotics, underusing urine culture tests, and other inappropriate care, especially for women who experience frequent UTIs.” Too much prescribing can also aid in creating bacteria that “evolve to resist treatment with common antibiotics.”
The paper contains two algorithms for prescribing – “one for non-pregnant women and the other for men – that clinicians in any setting can use to decide what tests to order, and when to prescribe antibiotics, for patients experiencing UTI-like symptoms.” The goal is to cut down on services that “deliver prescriptions to anyone who answers a questionnaire.”
The Ann Arbor UTI Guide addresses “less-common situations involving patients with more complicated health conditions, such as those with a history of organ transplants, chemotherapy, immunosuppression, kidney disease, and those with recurrent UTIs who have prescriptions for antibiotics that they take after sex or on an ongoing basis.” The guide also calls for “confirmation of UTI by culture wherever possible in cases where a urinalysis is abnormal, because of high levels of false positives.”
