This year was another incredibly busy one as community pharmacy is increasingly seen as the first point of contact for patients. There were a number of clinical developments.

NICE updates quality standards for UTI in adults

Three new standards and two updated pieces of guidance on urinary tract infections (UTIs) were published this year. The first standard states that women aged under 65 years are diagnosed with a UTI if they have two or more key urinary symptoms and no other excluding causes or warning signs.

The National Institute for Health and Care Excellence (NICE) explained that there was no single or combination of symptoms that are completely reliable in diagnosing a UTI so other causes of urinary symptoms, such as vaginal and urethral symptoms, need to be excluded – the presence of discharge or irritation reduce the probability of a UTI. It’s important to exclude vaginal infections and sexually transmitted diseases. The second and third new standards cover short courses of antibiotics sufficient for treating uncomplicated lower UTIs:

• Non-pregnant women with an uncomplicated lower UTI should be prescribed a three-day course of antibiotics, and men and pregnant women with an uncomplicated lower UTI should be prescribed a seven-day course
• Men with a recurrent UTI, and women with a recurrent lower UTI where the cause is unknown or a recurrent upper UTI, should be referred for specialist advice.

The two updated pieces of guidance are that men and non-pregnant women should not be prescribed antibiotics to treat asymptomatic bacteriuria, and adults with indwelling urinary catheters do not need to have dipstick testing to diagnose UTIs.