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  • 1 October 2015 to 28 February 2016
  • Project No: 170
  • Funding round: FR 10
  • Infection

Antibiotic resistance is rising and linked to prescribing in primary care.

It is a national priority to try and reduce prescribing antibiotics where possible and resistance to antibiotics is a particular problem with cystitis (urinary tract infection).

Cystitis in adult women is one of the most common conditions treated with antibiotics in primary care and although the symptoms are distressing, they usually settle without complications within a few days.

Antibiotics do shorten the duration of symptoms and so this form of treatment is currently used. An alternative treatment of delaying the prescription for a few days has been successful in respiratory infections, but in cystitis this results in only a small reduction in antibiotic prescribing but slightly prolonged symptoms.

It is unlikely however that the delayed prescribing strategy will be widely adopted unless an alternative approach for symptom relief is available. Two alternative products for symptom relief have been identified:- Anti inflammatory drugs (NSAIDs) and a herbal product (Arctostaphylos Uva ursi).

This study aims to find out if either of these products used during the period of delayed prescription would provide additional symptom relief. If so they would have the potential to change the way treatment is given and promoted in primary care and further reduce antibiotic prescribing.

Women presenting to their GP with suspected cystitis will be asked to accept a delayed prescription for antibiotics and then randomly selected to take one or both of the two medications to reduce symptoms. If their symptoms have not improved after 3-5 days or are getting worse then they will collect and take the antibiotics.

We will record symptom severity using a diary and the proportion of women using antibiotics in each group. This is an experienced research group who have previously run similar trials.

More information about the trial.

Evidence synthesis working group

The collaboration will be conducting 18 high impact systematic reviews, under four workstreams.

Find out more