Open Access

ARTICLE

Natural history of urinary tract infection in a primary care environment in Canada

J. Curtis Nickel¹, Jay C. Lee², John E. Grantmyre³, Dimitris Polygenis⁴

1 Department of Urology, Queen’s University, Kingston, Ontario, Canada
2 University of Calgary, Calgary, Alberta, Canada
3 Department of Urology, Dalhousie University, Halifax, Nova Scotia, Canada
4 McKesson Phase 4 Solutions, Toronto, Ontario, Canada
Address correspondence to Dr. J. C. Nickel, Department of Urology, Empire IV Kingston General Hospital, 76 Stuart Street, Kingston, Ontario K7L 2V7 Canada

Canadian Journal of Urology 2005, 12(4), 2728-2737.

Abstract

Objective: To characterize the natural history of uncomplicated urinary tract infection (uUTI) in a Canadian primary care environment from the patient's perspective.
Materials and methods: Female patients (n = 2323) with symptoms of uUTI were recruited by 581 family physicians who collected baseline demographic and clinical data and prescribed 500 mg/day extended release ciprofloxacin (Cipro® XL™). Follow-up data were collected 4 and 10 days later by patient telephone interview assessing uUTI symptoms, medication compliance, time to symptom resolution, impact on usual activities and overall satisfaction.
Results: Patients (mean age 40) had on average 3.56 uUTI symptoms at baseline, the most common of which was frequency (94% of patients). The mean duration of symptoms was 4.9 days. Sixty-three percent of patients reported an impact of uUTI on usual activities prior to antibiotic therapy with a mean impact score of 4.33 (scale 0 to 10 [maximum]). At day 4, uUTI symptoms had decreased to 0.74/patient, 71.5% of patients reported symptom resolution, while medication compliance was 97%. By day 10, uUTI symptoms had decreased further to 0.42/patient, 84.3% of patients had symptom resolution and only 13% reported a residual impact on usual activities (mean impact score, 0.76). Patients showed high levels of satisfaction (>80%) with all aspects of therapy.
Conclusions: Patients wait almost 5 days before seeking medical attention for uUTI and by that time symptoms can significantly impact normal activities. This assessment of symptoms and outcomes of uUTI provides physicians with a better view of the impact of infection on patients' lives.

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