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Women should be able to get antibiotics for urinary tract infection without a prescription

BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h3441 (Published 14 July 2015) Cite this as: BMJ 2015;351:h3441
  1. Kyle Knox, general practitioner, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6NW
  1. kyle.knox{at}phc.ox.ac.uk

Uncomplicated cystitis is common and easily treated with drugs such as nitrofurantoin. Kyle Knox asks why women cannot treat themselves, without using up precious appointments in general practice

Acute uncomplicated urinary tract infections (AUUTIs) are common, especially in premenopausal, sexually active women, of whom about 30% will have been affected by age 26.1 AUUTIs usually resolve without sequelae and rarely progress to pyelonephritis, but they result in considerable morbidity, and the goal of treatment is to ameliorate the severity and duration of symptoms.

The management of these AUUTIs should be relatively uniform because the causes and responses to oral antimicrobials are known and predictable. Public Health England’s guidance on their management can be summarised in a simple flowchart, which requires little clinical assessment.2 In an era of ready access to information, increasing patient autonomy, and overstretched primary care services, therefore, it would seem a good idea for women to be able to access safe and effective treatment without the costs and delays associated with consulting a clinician to get a prescription.

Three million appointments a year

Cystitis in women is coded as the reason for about 1% of …

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