Management options

Once UTI is established as the most likely cause, the next decision for the pharmacist to consider is whether to suggest use of an antibiotic. If symptoms are mild then it is reasonable to discuss pain relief and self care advice with the patient. Paracetamol (or ibuprofen if preferred and suitable) can be used for up to two days. NICE advice is to encourage intake of enough fluids to avoid dehydration but not to recommend cranberry products (although they may have a role in prevention) or urine alkalinising agents for symptoms.

In cases of uncomplicated UTI in women who have all three key features (dysuria, new nocturia and cloudy urine) it is no longer routine to send urine for culture and antibiotics are used empirically. The PGD for pharmacists is to use nitrofurantoin in England.

Acute, uncomplicated urinary tract infection (UTI) usually resolves within a few days with or without antibiotic treatment. The duration of a UTI treated with an antibiotic to which the pathogen is sensitive is around 1.5 days shorter than when not treated with an antibiotic (3.3 days vs 4.9 days).