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Women should be able to get antibiotics for urinary tract infection without a prescription | The BMJ
From their website;
Uncomplicated cystitis is common and easily treated with drugs such as nitrofurantoin. Kyle Knox asks why women cannot treat themselves, without using up precious appointments in general practice
Acute uncomplicated urinary tract infections (AUUTIs) are common, especially in premenopausal, sexually active women, of whom about 30% will have been affected by age 26.1 AUUTIs usually resolve without sequelae and rarely progress to pyelonephritis, but they result in considerable morbidity, and the goal of treatment is to ameliorate the severity and duration of symptoms.
In one of the online BMJ responses;
(The article) argues that: a) the clinical recognition of an uncomplicated cystitis does not require the assessment of a health professional, b) there is good evidence of the efficacy and safety of a 3 day-course of Nitrofurantoin, and c) the threat of a growing resistance to Nitrofurantoin do not outweigh the benefits of easy access to this antibiotic. Thus, why cannot women with an uncomplicated cystitis treat themselves, without using up precious appointments in general practice?
Dr Maureen Baker, Chair of the Royal College of GPs, said: “Cystitis can cause a huge amount of discomfort for patients, and whilst antibiotics can help in some cases, they are not always the most appropriate treatment as the cause is not always bacterial.
“Aside from the patient safety risks associated with deregulating access to some of these powerful drugs, we are currently amidst an international drive to reduce antibiotic use, in order to curb growing global resistance to them.
“Although the strain of antibiotics referenced in the article has actually seen very little resistance built up against it so far, making it more widely available would inevitably increase resistance to it and remove one of the few antibiotics with low resistance rates from the formulary, therefore adding to this global problem.
“GPs already face enormous pressure to prescribe antibiotics, and it often takes a lot of effort to persuade patients that they are not always the answer to treating illness – making them available without a prescription would simply undermine this. There is also the risk that bypassing the GP for patients with cystitis might lead to recurrent strains of the infection being treated inappropriately, and more serious conditions going undetected.
“Instead of increasing the availability of antibiotics for patients suffering from cystitis, we should concentrate our efforts on making alternative treatments to cystitis more widely available – and identifying new non-antibiotic strategies – to reduce the need for and resistance to the drugs, so that they will still be effective when our patients really need them.”