• Question: What are your thoughts on use of patient self completed questionnaires to support the management of acute UTI (supplementing healthcare professional questioning), and are you aware of a recommended version

    Asked by athomson11 on 19 Nov 2015.
    • Photo: Marco Boeri

      Marco Boeri answered on 19 Nov 2015:

      I am definitely in favour of using self completed questionnaires (supplementing healthcare professional questioning) to support the management of most infections, including UTI. Patients should be the centre of attention for treating infections, not the infection itself and questionnaire can work well as a reminder.

      Unfortunately, I am not aware of any recommended version, I will look into it.

    • Photo: Cliodna McNulty

      Cliodna McNulty answered on 23 Nov 2015:

      I think that questionnaires or a template in the primary care setting is useful for triaging young patients without any underlying risk factors for severe infection, however there is no substitute to seeing a patient and assessing them for signs of infection before making the decision to prescribe or not. This is particularly relevant in the elderly; E.coli bacteraemias have increased 3 fold over the past 10 years and therefore any clinical advice given(whether antibiotics are given or not) should be include safety netting advice.
      Having said that Public Health England have produced a quick reference guide for primary care staff that gives a flow chart on what to ask and when to give empirical antibiotics, perform a urine dipstick or culture.

      This guidance indicates that if a woman has severe or 3 or more urinary symptoms without vaginal discharge, this is highly indicative of UTI with 90% positive predictive value and empirical antibitics are warranted. If the woman has 2 symptoms only or they are mild then a urine specimen should be taken. If the urine is clear then this is highly suggestive that a UTI is not present with 97% negative predictive value. However if cludy a urine dipstick should be performed.
      The guidance also has lots of other useful advice – so this is similar to the questionnaire you are suggesting – but really for the clician to use.