title: Incidence, severity, help seeking, and management of uncomplicated urinary tract infection: a population-based survey.
abstract: BACKGROUND
  Limited knowledge of the population incidence and management of uncomplicated urinary tract infection (UTI) limits information provision and interventions to enhance care in the community.
  
  
  OBJECTIVE
  To describe incidence and severity, help seeking, and management of UTI from a population perspective.
  
  
  METHODS
  Household survey in England in 2014.
  
  
  METHODS
  In total, a random sample of 2424 females aged ≥16 years were interviewed in their own homes using computer-assisted interviewing about their UTI symptoms, help seeking, and management. Data were weighted by sex, age, ethnicity, working status, social grade, and housing tenure, and Government Office Region to be broadly representative of the general population.
  
  
  RESULTS
  Of the females interviewed, 892 (37%) reported having had at least one UTI in their lifetime (29% had more than one episode). In the past year, 11% of all females reported a UTI and 3% recurrent UTI (≥3 or more). Of those who had ever had a UTI, 48% rated their last UTI as fairly or very severe. In total, 95% consulted a health professional; 65% at their local GP practice during routine consulting hours. Out-of-hours consulting was uncommon but more prevalent in younger females. Of those contacting a health professional, 76% had a urine test, 74% were prescribed an antibiotic, but only 63% of these reported taking the antibiotic. Delayed antibiotic prescribing was rare.
  
  
  CONCLUSIONS
  UTI symptoms are common; most females consult in general practice, and are prescribed antibiotics, but one-third report not taking the antibiotics as prescribed. Benefit and harms in those taking, and not taking, antibiotics need to be better understood in order to improve help seeking, management, and adherence. Urine tests and antibiotics could be reduced by basing empirical antibiotics on symptoms, and increasing use of back-up prescriptions.
authors.affiliation: Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, and GP, Cwm Taf University Health Board, Wales.
authors.forename: Chris C
authors.initials: CC
authors.lastname: Butler
authors.affiliation: Public Health England Primary Care Unit, Microbiology Department, Gloucestershire Royal Hospital, Gloucester, UK.
authors.forename: Meredith K D
authors.initials: MK
authors.lastname: Hawking
authors.affiliation: Ipsos MORI Social Research Institute, London, UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Quigley
authors.affiliation: Public Health England Primary Care Unit, and visiting honorary professor, Cardiff University, Microbiology Department, Gloucestershire Royal Hospital, Gloucester, UK.
authors.forename: Cliodna A M
authors.initials: CA
authors.lastname: McNulty
mesh_terms: D000293:Adolescent; D000328:Adult; D000892:Anti-Infective Agents, Urinary / Q000627:therapeutic use*; D011307:Drug Prescriptions; D004739:England / Q000453:epidemiology; D005260:Female; D058006:General Practice / Q000379:methods; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D057226:Information Seeking Behavior; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D011634:Public Health; D011795:Surveys and Questionnaires; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000652:urine
chemical_list: D000892:Anti-Infective Agents, Urinary
keywords: anti-infective agents; consulting; diagnostic test, routine; epidemiology; primary care; urinary tract infection