title: The challenges of treating women with recurrent urinary tract infections in primary care: a qualitative study of GPs' experiences of conventional management and their attitudes towards possible herbal options.
abstract: OBJECTIVE
  To explore GPs' experiences of managing recurrent urinary tract infections (RUTIs) and their views on the use of herbal medicines for this condition.
  
  
  BACKGROUND
  RUTIs are an important problem commonly managed in primary care. Antibiotic prophylaxis is an effective treatment for acute infections but growing microbial resistance, adverse effects, and the lack of sustained long-term benefits mean that novel treatments are required. There are a number of promising reports of herbal medicines being used to treat RUTIs.
  
  
  METHODS
  A total of 15 GPs (seven female; aged 34-59 years; in practice from 3 to 31 years) were purposively sampled and took part in semi-structured face-to-face and telephone interviews. Interviews were digitally recorded, transcribed, and analysed using inductive thematic analysis. Data collection and analysis proceeded iteratively to allow emerging themes to inform subsequent interviews.
  
  
  RESULTS
  Participants were aware of the disabling effect of RUTIs on women's lives. GPs experienced significant challenges in their management of RUTIs with decisions about the provision of antibiotics being particularly complex. While some participants were open to the possibility of herbal treatment options they required more research into effectiveness and safety, better regulation of herbal practitioners, and assurance about herbal quality control and potential herb-drug interactions.
authors.affiliation: 1Research Fellow,Department of Primary Care and Population Sciences,University of Southampton,Southampton,Hampshire,UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Flower
authors.affiliation: 24th Year Medical Student,School of Medicine,University of Southampton,Southampton,Hampshire,UK.
authors.forename: David
authors.initials: D
authors.lastname: Winters
authors.affiliation: 3Lecturer in Health Psychology,University of Southampton,Southampton,Hampshire,UK.
authors.forename: Felicity L
authors.initials: FL
authors.lastname: Bishop
authors.affiliation: 4Professor of Health Research,Department of Primary Care and Population Sciences,University of Southampton,Southampton,Hampshire,UK.
authors.forename: George
authors.initials: G
authors.lastname: Lewith
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D019468:Disease Management; D005260:Female; D058005:General Practitioners; D029001:Herbal Medicine / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000379:methods*; D036301:Qualitative Research; D012008:Recurrence; D006113:United Kingdom; D014552:Urinary Tract Infections / Q000628:therapy*; D016387:Women's Health
keywords: GP experience; Recurrent UTIs; herbal medicine