Trial reportBMJ (Clinical research ed.)2010
Cost effectiveness of management strategies for urinary tract infections: results from randomised controlled trial.
Trial report 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 27 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
27 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Economic Burden of Community-Acquired Antibiotic-Resistant Urinary Tract Infections: Systematic Review and Meta-Analysis.JMIR public health and surveillance · 2024Pooled it
- Current evidence does not support systematic antibiotherapy prior to joint arthroplasty in patients with asymptomatic bacteriuria-a meta analysis.International orthopaedics · 2018Pooled it
- Uncomplicated Bacterial Community-Acquired Urinary Tract Infection in Adults.Deutsches Arzteblatt international · 2017Guideline
- Screening with urinary dipsticks for reducing morbidity and mortality.The Cochrane database of systematic reviews · 2015Pooled it
- Intermittent self catheterisation with hydrophilic, gel reservoir, and non-coated catheters: a systematic review and cost effectiveness analysis.BMJ (Clinical research ed.) · 2013Pooled it
- Article
- Rapid and accurate preoperative diagnosis of urinary tract infections in urolithiasis patients: clinical validation of the HB&L system.BMC infectious diseases · 2026Article
- Current Evidence on Safety, Efficacy and Efficiency of Sublingual Vaccine UromunePathogens (Basel, Switzerland) · 2025Review
- Performance of Gram Stain, Leukocyte Esterase, and Nitrite in Predicting the Presence of Urinary Tract Infections: A Diagnostic Accuracy Study.Archives of academic emergency medicine · 2025Article
- Sociodemographic disparities in antibiotic-resistant outpatient urine cultures in a Boston hospital, 2015-2020: a cross-sectional analysis.International journal for equity in health · 2024Article
- Recurrent Urinary Tract Infection in Adult Patients, Risk Factors, and Efficacy of Low Dose Prophylactic Antibiotics Therapy.Journal of epidemiology and global health · 2023Article
- Antibiotic prescription patterns in patients with suspected urinary tract infections in Ecuador.PloS one · 2023Article
- Preoperative bacteriuria positivity on urinalysis increases wound complications in primary total hip arthroplasty regardless of the urine culture result.BMC musculoskeletal disorders · 2021Observational
- Diagnosis of urinary tract infection based on symptoms: how are likelihood ratios affected by age? a diagnostic accuracy study.BMJ open · 2021Article
- Workload, diagnostic work-up and treatment of urinary tract infections in adults during out-of-hours primary care: a retrospective cohort study.BMC family practice · 2020Observational
- Top 10 Self Learning articles from 2017.Canadian family physician Medecin de famille canadien · 2019Article
- Cancer metabolomic markers in urine: evidence, techniques and recommendations.Nature reviews. Urology · 2019Review
- Elevated urine IL-10 concentrations associate withImmunity & ageing : I & A · 2019Article
- Knowledge and Practice Discordance in Treating Urinary Tract Infections.PRiMER (Leawood, Kan.) · 2018Article
- An evaluation of community-acquired urinary tract infection and appropriateness of treatment in an emergency department in Saudi Arabia.Therapeutics and clinical risk management · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
objectiveTo assess the cost effectiveness of different management strategies for urinary tract infections.
designCost effectiveness analysis alongside a randomised controlled trial with a one month follow-up.
settingPrimary care.
participants309 non-pregnant adult women aged 18-70 presenting with suspected urinary tract infection.
interventionsPatients were randomised to five basic management approaches: empirical antibiotics, empirical delayed (by 48 hours) antibiotics, or targeted antibiotics based on either a high symptom score (two or more of urine cloudiness, smell, nocturia, dysuria), dipstick results (nitrite or leucocytes and blood), or receipt of a positive result on midstream urine analysis.
main outcome measureDuration of symptoms and cost of care.
resultsManagement with targeted antibiotics with midstream urine analysis was more costly over the period of one month. Costs for the midstream urine analysis and dipstick management groups were pound37 and pound35, respectively; these compared with pound31 for immediate antibiotics. Cost effectiveness acceptability curves suggested that if avoiding a day of moderately bad symptoms was valued at less than pound10, then immediate antibiotics is likely to be the most cost effective strategy. For values over pound10, targeted antibiotics with dipstick testing becomes the most cost effective strategy, though because of the uncertainty we can never be more than 70% certain that this strategy truly is the most cost effective.
conclusionDipstick testing with targeted antibiotics is likely to be cost effective if the value of saving a day of moderately bad symptoms is pound10 or more, but caution is required given the considerable uncertainty surrounding the estimates.
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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.