Uncomplicated Urinary Tract Infections (UTI's) in women

Urinary tract infections (UTIs) affect your urinary tract, including your bladder (Cystitis), urethra (Urethritis) or kidneys (kidney infection). UTIs may be treated with antibiotics, but they're not always needed. They are also significantly more common in females compared to males.

Symptoms of a urinary tract infection (UTI) may include:

• Pain or a burning sensation when urinating (dysuria)
• Needing to urinate more often than usual
• Needing to urinate more often than usual during the night (nocturia)
• Needing to urinate suddenly or more urgently than usual
• Urine that looks cloudy or signs of blood in it
• Lower tummy pain or pain in your back, just under the ribs
• A high temperature, or feeling hot and shivery
• A very low temperature below 36C
• Dark and / or smelly urine is a common UTI symptom but If this is your only symptom, it might be because you've not been drinking enough fluids.

Causes of urinary tract infections (UTIs)

Urinary tract infections (UTIs) are usually caused by bacteria from faeces entering the urinary tract. The bacteria enter through the tube that carries urine out of the body (urethra).Women have a shorter urethra than men. This means bacteria are more likely to reach the bladder or kidneys and cause an infection.

Things that increase the risk of bacteria getting into the bladder include:

• Having sex
• Pregnancy
• Conditions that block the urinary tract e.g. kidney stones
• Conditions that make it difficult to fully empty the bladder e.g. enlarged prostate and constipation 
• Having a weakened immune system 
• Not drinking enough fluids
• Not keeping the genital area clean and dry

Because of the location of a community pharmacy, flexible opening times and difficulties getting a GP appointment patients / customers are going to their community pharmacy more and more for guidance and support with rergards to over the counter (OTC) products and self treatments for a UTI.

A pharmacist can sell products and offer guidance and support on things that can make you better and / or prevent infections in the first place for example:

• Suggest the best painkiller to take e.g Paracetamol which can help with a temperature as well
• Tell you if you need to test your urine and / or see a GP about your symptoms
• Suggest a home testing kit or complete the test in the pharmacy.  (2 SAN test kit available on Numarknet)

• Encouraging rest and drinking enough fluids so you pass pale urine regularly during the day
• Avoid having sex because it could be transmissible
• Encourage wiping from front to back when you go to the toilet
• Keeping the genital area clean and dry
• Drinking plenty of fluids, particularly water – so that you regularly urinate during the day and do not feel thirsty
• Washing the skin around the vagina with water before and after sex
• Urinating as soon as possible after sex
• Not using scented soap
• Not holding urine in if you feel the urge to go
• Not rushing when urinating– try to fully empty your bladder
• Not wearing tight synthetic underwear, such as nylon
• Not drinking too many alcoholic drinks, as they may irritate your bladder
• Not having too much sugary food or drinks, as they may encourage bacteria to grow

Because of the sensitivity of the subject the consultation should ideally be done away from other customers e.g. in a consultation room.

Under the Pharmacy 1st scheme if a UTI is confirmed and dependant on the patient themselves, the pharmacist may prescribe Nitrourantoin if certain criteria are met e.g.

• A dip stick (2 SAN test kit available on Numarknet) urine test completed shows positive infection signs 
• The patient falls into the correct age bracket for the prescribing
• The patient has the correct signs and symptoms to meet the prescribing criteria
• They do not fall into the excluded categories
• The registered healthcare professional should also have evidence of competence in the clinical skills and knowledge covered in the Centre for Pharmacy Postgraduate Education (CPPE) Pharmacy First Service self-assessment framework. This evidence can be found at the following link CPPE Pharmacy First. Numarknet has partnered with CIG our training provider and a downloadable document with links to the CIG website and enroling on the external CIG training can all be found at the following link ECG Pharmacy First . The document is called ECG Pharmacy First Training Booking Guide.