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Background The guideline on urinary tract infections (UTI) of the Dutch College of General Practitioners provides recommendations on patient‐initiated treatment and prevention of recurring UTI. Aim To study familiarity with self‐management skills for prevention of recurring UTI amongst adult women. Design and settings An online questionnaire was developed, based on the UTI guideline and interviews with women having recurring UTI. Pharmacists in a postgraduate education programme (N = 76) aimed to invite 10 adult women with a recurring UTI prescription to complete the questionnaire. Women were asked for informed consent to link medication record data to questionnaire data. Method We calculated proportions of the scores for self‐management skills and analysed differences between age groups with chi‐square test. Results Complete questionnaires were available for 719 women (mean age 55.1 ± 18.5 years). The proportions of women 18‐50 years and women 51 years or older were 36.4% and 63.6%, respectively. Education levels of women 18‐50 years were significantly higher than those of women 51 years and older. Before consulting a general practitioner (GP) for symptoms, 32.1% of all women increased fluid intake; additionally, 15.0% used analgesics and increased fluid intake. Of all women, 33.9% searched internet for information on self‐management and 18% occasionally received a prescription for patient‐initiated treatment, half of these prescriptions for use during vacation. Cranberry was used by 47%, d‐mannose by 5% and vitamin C by 29% of all women. Awareness of different preventive behavioural measures (eg, fluid intake, washing without soap and emptying bladder after sexual intercourse) varied between 20% and 90%. Conclusion Almost half of all women applied self‐management (increased fluid intake, analgesics) before consulting a GP for recurring UTI. Awareness of preventive behavioural measures for recurring UTI varied considerably. Thus, education of women about the use of analgesics and behavioural measures deserves attention.

Background Urinary tract infection (UTI) is one of the most prevalent medical conditions among women seeking primary care. About 20–40% of the women have a UTI recurrence during their lifetime. Objective To provide insight in the patterns of recurring annual dispensing for antibiotics commonly used for UTI treatment in women, aged 18 years or older, during a 5-year follow-up period in the Netherlands. Methods The Dutch Foundation of Pharmaceutical statistics collects dispensing data from more than 90% of all community pharmacies. Pharmacies with complete data between years 2011 and 2017 were included. Women of age 18 years or older with a first dispensing of nitrofurantoin, fosfomycin, or trimethoprim in 2012 and a dispensing of any medication in 2017 were selected. For each year between 2013 and 2017, the proportions of women with recurring dispensing of nitrofurantoin, fosfomycin or trimethoprim were calculated and stratified for age categories. Results Within 1517 eligible community pharmacies, 463 821 women, aged 18 years or older, were dispensed one of the antibiotics in 2012, and 239 292 women still visited the same pharmacy in 2017. About 56% of them received at least one recurring dispensing during 5 years of follow-up. Each year, ~20% of the source population had at least one recurring dispensing. Approximately 2% of the source population had at least one recurring dispensing in each year of follow-up. Conclusions Over the 5-year study period, more than 50% of the source population had at least one recurring dispensing for uncomplicated UTI, most of them with at least 1 year without UTI dispensing in between., Approximately 60% of women experience complaints of urinary tract infection (UTI) in their lifetime. This study investigated the pattern of recurring dispensing of the UTI guideline antibiotics nitrofurantoin, fosfomycin, and trimethoprim over a 5-year period. In 2012, 463 821 women aged 18 years or older visited a community pharmacy in the Netherlands for a first prescription since 2010 of one of the UTI guideline antibiotics. We selected 239 292 women, aged 18 years or older (mean age 54 years), who still visited the same pharmacy for any prescription in 2017. Most of the women included (85%) had a prescription for nitrofurantoin. In each year between 2013 and 2017, ~20% of the included women had a recurring dispensing of one of the UTI guideline antibiotics. Over the entire 5-year follow-up period, 56% of the women visited the pharmacy for at least one recurring UTI guideline antibiotic dispensing. Most of these women had at least 1 year without a dispensing of a UTI guideline antibiotic in between. Approximately 2% of the source population had at least one recurring dispensing in each year of follow-up.

Aim: To study whether changes in drug preferences in the Dutch guideline for the treatment of Urinary Tract Infection (UTI) for General Practitioners (GPs) in 2013, resulted in corresponding changes in antibiotic dispensing. Background: For the treatment of uncomplicated UTI, nitrofurantoin remained the first choice, while fosfomycin became the second choice and changed ranks with trimethoprim. For a subsequent febrile UTI, ciprofloxacin became the first choice and changed ranks with amoxicillin/clavulanic acid, co-trimoxazole remained the third choice. Methods: In this observational cross-sectional study, routinely collected dispensing data from the Dutch Foundation of Pharmaceutical Statistics from 2012 to 2017 were used. The number of women 18 years and older, treated with one of the guideline antibiotics for uncomplicated UTI and subsequent febrile UTI were analysed annually. Proportions were calculated. Data were stratified for age categories. Failure of uncomplicated UTI treatment was defined as the dispensing of an antibiotic for febrile UTI within 14 days after the dispensing of an antibiotic for uncomplicated UTI. Findings: Data were available from 81% of all pharmacies in 2012 to 89% in 2017. Percentages of women dispensed nitrofurantoin were relatively stable with 87.4% in 2012 and 84.4% in 2017. Percentages of women dispensed fosfomycin increased from 5.4% in 2012 to 21.8% in 2017, whereas percentages of women dispensed trimethoprim decreased from 17.8% to 8.0%. Within age categories, the percentage of women dispensed fosfomycin increased from 12.4% in women 18–30 years old to 36.7% in women above 80 years old. Percentages of women dispensed antibiotics for febrile UTI remained stable at 5% annually. Percentages of women receiving ciprofloxacin increased from 1.9% in 2012 to 3.3% in 2017, while those receiving amoxicillin/clavulanic acid decreased from 2.9% to 1.8%. New guideline recommendations resulted in corresponding changes in dispensed antibiotics for uncomplicated UTI and subsequent febrile UTI. Drug choices differed for age categories.