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The risk of a women developing a urinary tract infection in her lifetime is over 50%, approximately 25% of which become recurrent (rUTIs). This study examined the viewpoints of women with rUTIs through six focus groups at a tertiary centre and highlights many of the shortcomings in current management. Although this represented a small, homogeneous, well-educated sample of patients, the perspectives expressed are often heard at outpatient clinics and on social media posts. The themes addressed the negative impact of antibiotics on emergence of resistance and collateral damage to their gastrointestinal and genitourinary microbiomes, apprehension regarding antibiotics prescribed without confirmation of infection, or those prescribed for overactive bladder symptoms which are different from that of UTI. Concerningly, the participants in the study expressed frustration and anger at the medical profession for not addressing their fears and optimising antibiotic stewardship, for underestimating the burden of rUTIs on their lives, and for not exploring non-antibiotic options. As a result, many women had sought advice from herbalists and acupuncture practitioners. Future research should be directed at the needs of patients, which include techniques for rapid and accurate diagnosis, better understanding of the host microbiome and immune response, and development of effective non-antibiotic options.

Fear and frustration among women with recurrent urinary tract infections: findings from patient focus groups.
Scott VCS, Thum LW, Sadun T, et al.
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Jay Khastgir

Princess of Wales Hospital, Bridgend & Swansea University School of Medicine.

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