“Antibiotics or cranberry juice?” - A study to support the wellbeing of women with recurrent urinary tract infections

Research funded by the Health and Care Research Wales Faculty is looking to produce a decision aid to help women with recurrent urinary tract infections make informed decisions about their treatment options.

Recurrent urinary tract infections (UTIs) are defined as having two UTIs in six months, or three in 12 months. Recurrent UTIs are common in women, with an estimated prevalence in the UK of three per cent. 

Dr Leigh Sanyaolu, a GP in Torfaen and a Health and Care Research Wales / NIHR Doctoral Fellow at Cardiff University, said that “research has shown that about half of women will get at least one UTI during their lifetime and about 40 per cent of women will get another UTI within a year”.

He said: “Recurrent UTIs can have a big impact on women’s lives and impact their ability to work and function normally. They can also have a significant impact on women’s mental health and some worry about the possibility of further UTIs in the future”.

“Generally, the main treatment to prevent recurrent UTIs are long-term, low-dose antibiotics, which have been shown to be effective. The concern is the development of antibiotic resistant infections, but the effect of long-term antibiotics on resistance is currently not clear.”

“There are several non-antibiotic options, but their effectiveness is much less recognised. It’s vital to understand the long-term effects of antibiotics used for this condition and the effectiveness of alternative options.”

Dr Sanyaolu will use healthcare data from the Secure Anonymised Information Linkage (SAIL) Databank to get a more accurate picture of the burden of the condition.

The study will look over an 11-year period at women with recurrent UTIs. The research team will also look at those taking long-term antibiotics and those not and compare the effects on antibiotic resistance using anonymised hospital and urine sample data.

“We will also speak to women with recurrent UTIs and healthcare professionals working in primary care to understand what information they would like to know about treatments to prevent recurrent UTIs and guide the development of the decision aid,” he said.

Dr Sanyaolu is collecting and consolidating information on both the positives and negatives of the various treatment options for recurrent UTIs with his research to develop a decision aid about the best treatment option to prevent recurrent UTIs.

Treatment options may include long-term antibiotics, and other treatments like cranberry juice and methenamine which has recently been shown to be as effective as long-term antibiotics.

The decision aid will support discussions between women with recurrent UTIs and their healthcare professional around the pros and cons, evidence, side effects and rationale for each option to support shared decision-making to manage their condition.

Dr Sanyaolu added:

The decision aid will help to raise awareness of different treatment options. Putting this information out there and making it easily accessible for both patients and healthcare professionals is really important.”

Being a GP and healthcare professional, Dr Sanyaolu is devoted to focus his research in this area with an ambition to give hope for women living with the condition.

He said:

I'm interested in urinary tract infections and improving antibiotic use. I've seen women with recurrent UTIs and I understand the significant impact it can have on them. I'm doing what I can to improve the care of patients, not just my own, but also patients in general.”

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