Intended for healthcare professionals

CCBYNC Open access

Which treatment strategy for women with symptoms of urinary tract infection?

BMJ 2015; 351 doi: (Published 29 December 2015) Cite this as: BMJ 2015;351:h6888
  1. Lars Bjerrum, professor1,
  2. Morten Lindbæk, professor2
  1. 1Faculty of Health and Medical Sciences, Section of General Practice, University of Copenhagen, Oester Farimagsgade 5, DK-1014, Copenhagen, Denmark
  2. 2Antibiotic Centre for Primary Care, Department of General Practice, Institute of Health and Society, University of Oslo, PO Box 1130 Blindern, 0317 Oslo, Denmark
  1. Correspondence to: L Bjerrum Lbjerrum{at}

Many women could avoid antibiotics

Uncomplicated urinary tract infection (UTI) is the most common bacterial infection in women. Most women experience at least one episode during their lives, and each year about 10% receive one or more courses of antibiotics for UTI.1 2 Most women with typical symptoms are treated empirically, though up to half of them do not have clinically significant bacteriuria, and evidence indicates that many women with symptoms of UTI will recover without antibiotic treatment.3

Studies that compared antibiotics with placebo in women with uncomplicated UTI report a delayed cure in the placebo group, but most become symptom free within a week.3 4 Prescribing antibiotics to patients with self limiting conditions contributes to antimicrobial resistance. The World Health Organization considers antimicrobial resistance to be one of the three most important public health problems globally, and initiatives to reduce inappropriate and superfluous prescribing are essential if we are to maintain effective antibiotic treatment for future generations.

In a linked paper, Gágyor and colleagues (doi:10.1136/bmj.h6544) report a pragmatic double blind trial to investigate …

View Full Text