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Women’s views about management and cause of urinary tract infection: qualitative interview study

BMJ 2010; 340 doi: (Published 05 February 2010) Cite this as: BMJ 2010;340:c279
  1. G M Leydon, senior researcher and NIHR fellow1,
  2. S Turner, senior research fellow2,
  3. H Smith, chair in primary care3,
  4. P Little, professor of primary care research1
  5. on behalf of the UTIS team
  1. 1Primary Medical Care, Community Clinical Sciences Division, University of Southampton School of Medicine, Aldermoor Health Centre, Southampton SO16 5ST
  2. 2NIHR Public Health Research Programme NETSCC, Alpha House, University of Southampton Science Park, Southampton SO16 7NS
  3. 3Brighton and Sussex Medical School, University of Brighton, Brighton BN1 9PH
  1. Correspondence to: G M Leydon gerry{at}
  • Accepted 23 October 2009


Objectives To explore the views of women with urinary tract infection on the acceptability of different strategies for managing the infection, including delayed use of antibiotics, and the cause of infection.

Design Qualitative interview study with semistructured one to one interviews within a randomised controlled trial of different management strategies. Analysis drew on some of the principles of constant comparison to generate key themes grounded in reported experiences and understandings.

Setting Seven general practices across four counties in southern England.

Participants 21 women presenting to general practices who were taking part in the larger trial.

Results Women preferred not to take antibiotics and were open to alternative management approaches. With a strategy of “antibiotic delay” some women felt a lack of validation or that they were not listened to by their general practitioner. Women attributed urinary tract infection to lifestyle habits and behaviours, such as poor hygiene, general “negligence,” and even a “penalty of growing old.”

Conclusion A clear acknowledgment of women’s triggers to consult is needed. If women are asked to delay taking antibiotics, the clinician must address the particular worries that women might have and explain the rationale for not using antibiotics immediately.


  • We thank the practices that took part in the study and the patients who gave their time and shared their experiences and thoughts. The UTIS team comprises (in alphabetical order) C Hawke, J Lowes, K Martinson, MV Moore, MA Mullee, D Turner, and G Warner.

  • Contributors: PL had the original idea for the overall protocol and led the funding application. GML had the idea for the qualitative component of the study. All authors contributed to the development of the protocol and overall supervision of the study. ST, the trial coordinator, conducted the interviews with GML. GML and PL led the qualitative analysis and drafted the paper. All authors contributed to the writing of the final version of the paper. GML is guarantor.

  • Funding: This work was supported by the Health Technology Assessment programme grant reference: 97/14/06. The HTA had no involvement in the research process or writing of this article.

  • Competing interests: None declared.

  • Ethical approval: The study was approved by the local research ethics committee for Southampton and South West Hampshire (MREC/03/6/11) and informed consent was given by all patients.

  • Data sharing: No additional data available.

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