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Patient-Centered Approach to Treating UTIs: Seeking Consensus Through Controversies

Uncomplicated UTIs (Urinary Tract Infections) can have a detrimental impact on emotional wellbeing. Patients may feel ignored by their clinicians, who face a diverse set of challenges when managing uncomplicated UTIs, all of which are important to address when keeping the plan patient-centered. In this podcast, we will discuss patient-clinician communication barriers and the importance of patient[1]centered outcomes in managing uncomplicated UTIs.

Disclaimers:

1. This presentation is sponsored by GSK. The speakers are GSK paid healthcare providers. The content is intended to support disease state education and is considered nonpromotional.
2. The content and views expressed therein do not necessarily reflect the views, policies, or position of Pri-Med. This program is limited to Health Care Professionals (HCPs) only. GSK complies with all state and federal laws including transparent reporting and disclosure of payments and transfers of value to HCPs.

 

References:

1. Hilt EE, McKinley K, Pearce MM, et al. Urine is not sterile: use of enhanced urine culture techniques to detect resident bacterial flora in the adult female bladder. J Clin Microbiol. 2014;52(3):871-876. doi:10.1128/JCM.02876-13
2. Lindsay LE, et al. Clinical Practice Guideline for the Management of Asymptomatic Bacteriuria: 2019 Update by the Infectious Diseases Society of America. Clin Infect Dis 68, no. 10 (May 2, 2019): e83–110. https://doi.org/10.1093/cid/ciy1121
3. Advani SD, Polage CR, Fakih MG. Deconstructing the urinalysis: A novel approach to diagnostic and antimicrobial stewardship. Antimicrob Steward Healthc Epidemiol. 2021;1(1):e6. doi: 10.1017/ash.2021.167. Epub 2021 Jun 28. PMID: 34604864; PMCID: PMC8486290
4. FDA Drug Safety Communication. FDA. 2016. Accessed October 10, 2022 https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety[1]communication-fda-advises-restricting-fluoroquinolone-antibiotic-use-certain
5. Anger J, Lee U, Ackerman AL, et al. Recurrent uncomplicated urinary tract infections in women: AUA/CUA/SUFU guideline. J Urol. 2019;202(2):282-289. doi: 10.1097/JU.00000000000002963
6. Thompson J, Marijam A, Mitrani-Gold FS, Wright J, Joshi AV. Activity impairment and health-related emotional wellbeing associated with an uncomplicated urinary tract infection among US females. Oral presentation at: IDWeek 2021; September 29-October 3, 2021; Virtual Conference. Session: UTIs; presentation 196

7.Colgan R, Keating K, Dougouih M. Survey of symptom burden in women with uncomplicated urinary tract infections. Clin Drug Investig. 2004;24(1):55-60. doi: 10.2165/00044011-200424010-00007

8. Thompson J, Marijam A, Mitrani-Gold FS, Wright J, Joshi AV. A survey study of healthcare resource use, and direct and indirect costs, among females with an uncomplicated urinary tract infection in the United States. Poster presented at: IDWeek 2021; September 29-October 3, 2021. Poster 1227
9. Grigoryan L, Mulgirigama A, Powell M, Schmiemann G. The emotional impact of urinary tract infections in women: a qualitative analysis. BMC Womens Health. 2022;22(1):182. doi: 10.1186/s12905-022-01757-3
10. Scott VC, Thum LW, Sadun T, et al. Fear and frustration among women with recurrent urinary tract infections: findings from patient focus groups. J Urol. 2021;206(3):688-695. doi: 10.1097/JU.0000000000001843
11. Lecky DM, Howdle J, Butler CC, McNulty CA. Optimising management of UTIs in primary care: a qualitative study of patient and GP perspectives to inform the development of an evidence-based, shared decision-making resource. Br J Gen Pract. 2020;70(694):e330-e338. doi: 10.3399/bjgp20X708173
12. Chwa A, Kavanagh K, Linnebur SA, Fixen DR. Evaluation of methenamine for urinary tract infection prevention in older adults: a review of the evidence. Ther Adv Drug Saf. 2019;10:2042098619876749. Published 2019 Sep 23. doi:10.1177/2042098619876749
13. Harding C, Mossop H, Homer T, etal. Alternative to prophylactic antibiotics for the treatment of recurrent urinary tract infections in women: multicentre, open label, randomised, non-inferiority trial. BMJ 2022;376:e068229. doi: 10.1136/bmj-2021-0068229
14. Wade C, et al. Methenamine Prophylaxis for Recurrent Urinary Tract Infections in a Tertiary Referral Center. Urol Pract 2021;8(8):699-704
15. Hoffmann TC. Methenamine hippurate for recurrent urinary tract infections. BMJ 2022; 376
16. De Paepe H, Hoebeke P, Renson C, et al. Pelvic-floor therapy in girls with recurrent urinary tract infections and dysfunctional voiding. Br J Urol. 1998;81 Suppl 3:109-113. doi:10.1046/j.1464-410x.1998.00021.x
17. Hooton TM, Vecchio M, Iroz A et al. Effect of increased daily water intake in premenopausal women with recurrent urinary tract infections. JAMA Intern Med 2018; 178: 1509
18. Gupta K, Hooton TM, Naber KG, et al.; Infectious Diseases Society of America; European Society for Microbiology and Infectious Diseases. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52(5):e103-e120. doi: 10.1093/cid/ciq257

Is an Uncomplicated UTI Really Uncomplicated?

The controversy surrounding whether to collect urine cultures and which empiric treatment to prescribe in patients with uncomplicated UTI has left many clinicians unsure of the right approach. In this the first episode of a podcast series, we’ll discuss the definition of clinical cure and dive into the evidence behind grey areas in the diagnosis and management of uncomplicated UTI.

Disclaimers:

1. This presentation is sponsored by GSK. The speakers are GSK paid healthcare providers. The content is intended to support disease state education and is considered nonpromotional.
2. The content and views expressed therein do not necessarily reflect the views, policies, or position of Pri-Med. This program is limited to Health Care Professionals (HCPs) only. GSK complies with all state and federal laws including transparent reporting and disclosure of payments and transfers of value to HCPs.

 

References:

1. Gupta K, Hooton TM, Naber KG, et al.; Infectious Diseases Society of America; European Society for Microbiology and Infectious Diseases. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52(5):e103- e120. doi: 10.1093/cid/ciq2572.
2. Anger J, Lee U, Ackerman AL, et al. Recurrent uncomplicated urinary tract infections in women: AUA/CUA/SUFU guideline. J Urol. 2019;202(2):282-289. doi: 10.1097/JU.00000000000002963
3. Houlbar M, Meng L. SHC Clinical Pathway: Inpatient Management of Urinary Tract Infections – Adult Patients. Stanford Antimicrobial Safety and Sustainability Program. November 2017. https://med.stanford.edu/content/dam/sm/bugsanddrugs/documents/c linicalpathways/SHC-UTI-Inpatient-Guideline.pdf. Accessed November 30, 2022.
4. Hooton TM, Gupta K. Acute simple cystitis in women. UpToDate. Updated March 15, 2021. Accessed November 9, 2022. https://www.uptodate.com/contents/acute-simple-cystitis-in-women
5. Colgan R, Williams M. Diagnosis and treatment of acute uncomplicated cystitis. Am Fam Physician. 2011;84(7):771-776.
6. Shafrin J, Marijam A, Joshi AV, et al. Impact of suboptimal or inappropriate treatment on healthcare resource use and cost among patients with uncomplicated urinary tract infection: an analysis of integrated delivery network electronic health records. Antimicrob Resist Infect Control. 2022;11(1):133. Published 2022 Nov 4. doi:10.1186/s13756-022-01170-3
7. Daneman N, Chateau D, Dahl M, et al. Fluoroquinolone use for uncomplicated urinary tract infections in women: a retrospective cohort study. Clin Microbiol Infect. 2020;26(5):613-618. doi:10.1016/j.cmi.2019.10.016
8. Bratsman A, Mathias K, Laubscher R, Grigoryan L, Rose S. Outpatient fluoroquinolone prescribing patterns before and after US FDA boxed warning. Pharmacoepidemiol Drug Saf. 2020;29(6):701-707. doi:10.1002/pds.5018
9. FDA Drug Safety Communication. FDA. 2019. Accessed October 10, 2022 https://www.fda.gov/drugs/drug-safety-and-availability/fda-warns[1]about-increased-risk-ruptures-or-tears-aorta-blood-vessel[1]fluoroquinolone-antibiotics
10. Nicolle LE; AMMI Canada Guidelines Committee*. Complicated urinary tract infection in adults. Can J Infect Dis Med Microbiol. 2005;16(6):349- 360. doi:10.1155/2005/385768

Meet The Patient: Decoding IBS-D in Your Practice

Diagnosing and treating IBS-D can be challenging. On IBS-D(ecoded), host Susan Brazil gets the latest facts about IBS-D, and real life patients share their experiences living with IBS-D. In Episode 1, patient Molly from Atlanta discusses her symptoms and frustrations since being first diagnosed with IBS-D ten years ago. Expert physician Dr. Gregory Sayuk introduces treatment options..

US-VBZ-220064 09/22

This content is developed exclusively by or on behalf of the industry sponsor through a third party and is not reviewed by Pri-Med. The content and opinions expressed are those of the sponsor or presenters and may not reflect the views of Pri-Med.

Meet The Experts: Using the Symptoms to Decode IBS-D

IBS-D was once a diagnosis of exclusion. If a patient didn’t test positive for other gastrointestinal conditions, IBS-D was considered possible. On this episode of IBS-D(ecoded), experts who have been involved in both the research and treatment of IBS-D discuss the symptoms that may help health care providers make an efficient, reliable diagnosis.

US-VBZ-220064 09/22

This content is developed exclusively by or on behalf of the industry sponsor through a third party and is not reviewed by Pri-Med. The content and opinions expressed are those of the sponsor or presenters and may not reflect the views of Pri-Med.

Meet Nico & Christine: Their IBS-D Journeys Decoded

IBS-D can affect people of all ages, from all walks of life. On this third and final episode of IBS-D(ecoded), we meet two more patients. Nico is a young man who was first diagnosed with IBS-D while in college. Christine is in her 60s and has lived with abdominal pain and diarrhea for decades. Our expert gastroenterologists discuss these patients’ symptoms and treatment options. Then patient Molly, whom we met in Episode 1, returns with some important advice for both health care providers and patients.

US-VBZ-220064 09/22

This content is developed exclusively by or on behalf of the industry sponsor through a third party and is not reviewed by Pri-Med. The content and opinions expressed are those of the sponsor or presenters and may not reflect the views of Pri-Med.

Episode 5: Sex Differences

Join Dr Hillary Norton and Amanda Mixon, PA as they discuss the sex differences in the presentation of axSpA

Dr Norton is a board-certified rheumatologist based in Santa Fe

Amanda Mixon earned her PA certification at Michigan State University

This podcast is sponsored by Novartis Medical Affairs, and the speakers have been compensated for their time.

This podcast is part of the Think Back: Insights Into Axial Spondyloarthritis curriculum.

Episode 4: IBP vs MBP

Join Dr Robert Sallis and Dr Steve Lee as they discuss the differentiation of inflammatory back pain and mechanical back pain in axSpA

Dr Sallis is a family physician at Kaiser Permanente in Fontana, California, and a clinical professor at the University of California Riverside School of Medicine.

Dr Lee is a practicing rheumatologist in Fontana, California

This podcast is sponsored by Novartis Medical Affairs, and the speakers have been compensated for their time.

This podcast is part of the Think Back: Insights Into Axial Spondyloarthritis curriculum.

Episode 3: Referral Tools

Join Dr Abhijeet Danve and Dr Neal Skolnik as they describe how to recognize axSpA among patients with chronic back pain and which patients to refer to rheumatology

Dr Danve is an academic rheumatologist at the Yale School of Medicine in New Haven, Connecticut

Dr Skolnik is an academic family physician at Abington Jefferson Health in Abington, Pennsylvania

This podcast is sponsored by Novartis Medical Affairs, and the speakers have been compensated for their time.

This podcast is part of the Think Back: Insights Into Axial Spondyloarthritis curriculum.

 

 

Episode 1: Peripheral Symptoms

Join Dr Reeti Joshi and Dr Ethan Craig as they discuss the peripheral symptoms that can help health care practitioners better diagnose axSpA

Dr Joshi is a rheumatology specialist in Beaumont, Texas

Dr Craig is a rheumatologist at the University of Pennsylvania

This podcast is sponsored by Novartis Medical Affairs, and the speakers have been compensated for their time.

This podcast is part of the Think Back: Insights Into Axial Spondyloarthritis curriculum.

Episode 2: When Pain Hides Inflammatory Disease

Join Dr Neil Skolnik and Dr Ethan Craig as they discuss the underlying biological processes in axSpA

Dr Skolnik is an academic family physician at Abington Jefferson Health in Abington, Pennsylvania

Dr Craig is a rheumatologist at the University of Pennsylvania

This podcast is sponsored by Novartis Medical Affairs, and the speakers have been compensated for their time.

This podcast is part of the Think Back: Insights Into Axial Spondyloarthritis curriculum.