title: Antibiotic treatment of urinary tract infection by community pharmacists: a cross-sectional study.
abstract: BACKGROUND
  Urinary tract infections (UTIs) are one of the most common conditions seen in female patients within primary care. Community pharmacists are familiar with symptomatic UTI management and supplying trimethoprim under patient group direction (PGD) for moderate-to-severe uncomplicated UTIs could improve patient access to treatment.
  
  
  OBJECTIVE
  To compare the care pathway of patients with UTI symptoms attending GP services with those receiving management, including trimethoprim supply under PGD, via community pharmacies.
  
  
  METHODS
  Prospective, cross-sectional, mixed methods approach in 10 community pharmacies within NHS Greater Glasgow and Clyde.
  
  
  METHODS
  Pharmacies invited a purposive sample of female patients to participate. Pharmacists had the option of supplying trimethoprim under PGD to patients with moderate-to-severe infection meeting the PGD inclusion criteria. Data from patient (questionnaires and semi-structured telephone interviews) and pharmacist (questionnaires and semi-structured, face-to-face interviews) were quantitatively and qualitatively analysed.
  
  
  RESULTS
  Data were recorded on 153 patients, 97 presenting with GP prescriptions and 56 presenting directly in the pharmacy with symptoms suggestive of UTI, of whom 41 received trimethoprim via PGD and 15 received symptomatic management. Both GP adherence to local infection management guidelines and pharmacist application of PGD inclusion/exclusion criteria required improvement. There was demand and support, from patients and pharmacists, for access to antibiotic treatments for UTIs, without prescription, through community pharmacies.
  
  
  CONCLUSIONS
  Operating within PGD controls, antibiotic treatments for UTIs could be provided via community pharmacy to improve patient access to treatment which may also maintain antibiotic stewardship and reduce GP workload.
authors.affiliation: Pharmaceutical Public Health, NHS Greater Glasgow and Clyde, Glasgow, UK.
authors.forename: Jill L
authors.initials: JL
authors.lastname: Booth
authors.forename: Alexander B
authors.initials: AB
authors.lastname: Mullen
authors.forename: David A M
authors.initials: DA
authors.lastname: Thomson
authors.forename: Christopher
authors.initials: C
authors.lastname: Johnstone
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Galbraith
authors.forename: Scott M
authors.initials: SM
authors.lastname: Bryson
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: McGovern
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000892:Anti-Infective Agents, Urinary / Q000627:therapeutic use*; D003157:Community Pharmacy Services; D003430:Cross-Sectional Studies; D005260:Female; D058006:General Practice; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012606:Scotland / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014295:Trimethoprim / Q000627:therapeutic use*; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D000892:Anti-Infective Agents, Urinary; D014295:Trimethoprim
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