UTI supply

Question 1

What is the purpose of pharmacist-initiated treatment of urinary tract infection?

Answer 1

To authorise Registered Pharmacists to supply antibiotics for uncomplicated UTI in female patients aged 18 to 65 years

This treatment is specifically for uncomplicated urinary tract infections.

Question 2

Which medicines are approved for the treatment of uncomplicated UTI?

Answer 2

• Nitrofurantoin
• Trimethoprim

These medicines are listed in Appendix 2.

Question 3

What are the age and anatomical requirements for patients receiving treatment?

Answer 3

Patients must be aged between 18 and 65 years with an anatomical female urinary tract

This applies to those presenting with symptoms indicative of uncomplicated UTI.

Question 4

What must a pharmacist confirm before supplying antibiotic treatment?

Answer 4

The patient has not been treated for a UTI in the past 6 months or has had more than 2 infections in the past 12 months

This is to ensure appropriate treatment and avoid over-prescription.

Question 5

Where must the approved medicines be supplied from?

Answer 5

A pharmacy registered in Western Australia

This is a regulatory requirement for the treatment process.

Question 6

What is required to maintain during the consultation at the pharmacy?

Answer 6

Confidentiality of the consultation

There must be a suitable area in the pharmacy for this purpose.

Question 7

What must be completed as part of the treatment process?

Answer 7

A comprehensive clinical record of treatment and a service summary for the patient and/or their primary health provider

This ensures proper documentation and follow-up.

Question 8

How must the supply, packaging, and labelling of the approved medicines be conducted?

Answer 8

In accordance with Part 9 of the Medicines and Poisons Regulations 2016

Compliance with regulations ensures safety and standardization.

Question 9

What is the record-keeping requirement for the supply of antibiotics?

Answer 9

In accordance with Part 12 of the Medicines and Poisons Regulations 2016

This is essential for accountability and regulatory compliance.

Question 10

What must be done with the details of the supply?

Answer 10

Transmitted to My Health Record

This facilitates continuity of care and access to patient records.

Question 11

What is the maximum quantity of Nitrofurantoin that can be supplied?

Answer 11

20 tablets or capsules

This is specified for treatment in accordance with local resistance patterns.

Question 12

What is the maximum quantity of Trimethoprim that can be supplied?

Answer 12

3 tablets or capsules

Like Nitrofurantoin, this is also determined by local resistance patterns.

Question 13

How do you explain the condition to someone?

Answer 13

• ## A urinary tract infection or UTI is a common bacterial infection that affects 1 in 4 biological women in their lifetime

Question 14

How old are you?

Answer 14

Refer if under 18 or above 65

Question 15

What symptoms are you experiencing?

Answer 15

Look for:
- Dysuria (pain/burning on urination)
- Urinary urgency/frequency
- Suprapubic pain/discomfort

Refer if:
- Only one primary symptom is present
- Symptoms are atypical (e.g., vaginal discharge, odour, itch) – consider STI, vaginal candidiasis, or bacterial vaginosis

Symptoms suggest pyelonephritis:
Fever >38°C
Chills, rigors
Back/flank pain
Nausea or vomiting

Question 16

When did your symptoms start?

Answer 16

Refer if:
- Symptoms persist >48–72 hours after starting antibiotics
- Symptoms reoccur within 2 weeks of treatment completion (possible relapse)

Question 17

Have you had a UTI before?

Answer 17

Refer if:
- This is your first UTI and it hasn’t been diagnosed by a doctor
- Recurrent UTI:
–> ≥2 UTIs in the last 6 months
–> ≥3 UTIs in the last 12 months
–> History of pyelonephritis

Question 18

Are you pregnant or recently had a baby (postpartum)?

Answer 18

Refer if yes

Question 19

Do you have any other health conditions?

Answer 19

Prompt about:
* Diabetes
* Renal impairment/disease
* Immunocompromised status
* Urinary tract abnormalities (e.g., kidney stones, bladder prolapse)
* Neurogenic bladder
Refer if:
Any of these conditions are present – complicated UTI

Question 20

Are you taking any medications? Have you used antibiotics recently?

Answer 20

• Used antibiotics in last 3 months
• Taking meds that interact with trimethoprim or nitrofurantoin
• Concurrent meds contraindicate antibiotic choice

Question 21

Have you travelled overseas in the last 3 months?

Answer 21

Refer if yes – risk of multidrug-resistant bacteria

Question 22

Do you have an IUD?

Answer 22

If yes, refer - increased risk for recurrent or complicated uti

Question 23

Are you sexually active? How many partners have you had in the last 6 months?

Answer 23

If multiple, risk of STI. Refer

Question 24

Have you been in hospital lately or had any medical incidents?
(other patient factors)

Answer 24

Refer if:
* Hosp or residential care recently
* Had a urinary catheter in the last 48 hours (instrumentation risk factor)

Question 25

Counselling advice

Answer 25

* Please see your GP if any of these symptoms reoccur within 2 weeks of completing the course of antibiotics or if your Sx persist 48-72 hours after starting the antibiotics