ArticleBMJ (Clinical research ed.)2010
Presentation, pattern, and natural course of severe symptoms, and role of antibiotics and antibiotic resistance among patients presenting with suspected uncomplicated urinary tract infection in primary care: observational study.
Article in BMJ (Clinical research ed.), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
65 citing papers in PubMed, 4 syntheses or guidelines pooled it, 132 citations in OpenAlex.
- Natural history of uncomplicated urinary tract infection without antibiotics: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Pooled it
- Is Non-Steroidal Anti-Inflammatory Therapy Non-Inferior to Antibiotic Therapy in Uncomplicated Urinary Tract Infections: a Systematic Review.Journal of general internal medicine · 2020Pooled it
- Implications of Antibiotic Resistance for Patients' Recovery From Common Infections in the Community: A Systematic Review and Meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Pooled it
- Chinese herbal medicine for treating recurrent urinary tract infections in women.The Cochrane database of systematic reviews · 2015Pooled it
- Early Symptom Response in Patients With Uncomplicated Urinary Tract Infection Treated With Gepotidacin or Nitrofurantoin: Pooled Analysis From Two Pivotal Phase 3 Studies.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Trial
- Trial
- Risk factors for treatment failure in women with uncomplicated lower urinary tract infection.PloS one · 2021Trial
- Clinical relevance of bacterial resistance in lower respiratory tract infection in primary care: secondary analysis of a multicentre European trial.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Trial
- Reducing antibiotic use for uncomplicated urinary tract infection in general practice by treatment with uva-ursi (REGATTA) - a double-blind, randomized, controlled comparative effectiveness trial.BMC complementary and alternative medicine · 2018Trial
- Trial
- Ibuprofen versus pivmecillinam for uncomplicated urinary tract infection in women-A double-blind, randomized non-inferiority trial.PLoS medicine · 2018Trial
- Point-of-care urine culture for managing urinary tract infection in primary care: a randomised controlled trial of clinical and cost-effectiveness.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Trial
- Symptomatic treatment of uncomplicated lower urinary tract infections in the ambulatory setting: randomised, double blind trial.BMJ (Clinical research ed.) · 2017Trial
- Trial
- Trial
- A randomized controlled trial of a diagnostic algorithm for symptoms of uncomplicated cystitis at an out-of-hours service.Scandinavian journal of primary health care · 2015Trial
- Immediate versus conditional treatment of uncomplicated urinary tract infection - a randomized-controlled comparative effectiveness study in general practices.BMC infectious diseases · 2012Trial
- Effectiveness of five different approaches in management of urinary tract infection: randomised controlled trial.BMJ (Clinical research ed.) · 2010Trial
- URICA Study: Diagnosis and Management of Recurrent Acute Bacterial Cystitis in Women With Urinary Behavioral Therapy.Infectious diseases and therapy · 2026Article
- Non-antibiotic treatments for the management of recurrent urinary tract infection in the multidrug resistance era: A narrative review.Investigative and clinical urology · 2026Review
5 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by[Not Available].2010
Authors and funding
11 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess the natural course and the important predictors of severe symptoms in urinary tract infection and the effect of antibiotics and antibiotic resistance.
designObservational study.
settingPrimary care.
participants839 non-pregnant adult women aged 18-70 presenting with suspected urinary tract infection.
main outcome measureDuration and severity of symptoms.
results684 women provided some information on symptoms; 511 had both laboratory results and complete symptom diaries. For women with infections sensitive to antibiotics, severe symptoms, rated as a moderately bad problem or worse, lasted 3.32 days on average. After adjustment for other predictors, moderately bad symptoms lasted 56% longer (incidence rate ratio 1.56, 95% confidence interval 1.22 to 1.99, P<0.001) in women with resistant infections; 62% longer (1.62, 1.13 to 2.31, P=0.008) when no antibiotics prescribed; and 33% longer (1.33, 1.14 to 1.56, P<0.001) in women with urethral syndrome. The duration of symptoms was shorter if the doctor was perceived to be positive about diagnosis and prognosis (continuous 7 point scale: 0.91, 0.84 to 0.99; P=0.021) and longer when the woman had frequent somatic symptoms (1.03, 1.01 to 1.05, P=0.002; for each symptom), a history of cystitis, urinary frequency, and more severe symptoms at baseline.
conclusionAntibiotic resistance and not prescribing antibiotics are associated with a greater than 50% increase in the duration of more severe symptoms in women with uncomplicated urinary tract infection. Women with a history of cystitis, frequent somatic symptoms (high somatisation), and severe symptoms at baseline can be given realistic advice that they are likely to have severe symptoms lasting longer than three days.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.