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

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 patient's lives.