Capella FPX 4905 Assessment 5
Name
Capella University
NURS-FPX4025 Research and Evidence-Based Decision Making
Prof. Name
Date
Urinary tract infections (UTIs) are a prevalent health concern causing significant discomfort and healthcare visits among women. Common symptoms involve urinary urgency, frequency, painful urination, and suprapubic pain. In the United States, it is estimated that approximately 41% of women will experience a UTI in their lifetime, with around 10% encountering one each year (Bono et al., 2025). Recurring infections not only impair quality of life but also increase healthcare demands. This discussion centers on the application of evidence-based prophylactic antibiotic therapy to manage recurrent UTIs in women of reproductive age, examining updated findings on strategies designed to enhance clinical outcomes.
In adult women, UTIs present a persistent health issue, often challenging the immune system’s ability to ward off repeat infections. Consequences can escalate to complications such as kidney damage or sepsis. Symptoms typically include urgency, painful urination, and occasionally fever or flank pain in severe episodes (Bono et al., 2025). Frequent hospital readmissions are a notable risk for those suffering from recurrent UTIs, often linked to delayed recovery and complications like fluid retention.
The recurrence rate remains high, with nearly half of affected women developing another UTI within a year, especially among those aged 16 to 35 (Bono et al., 2025). UTIs contribute notably to healthcare burdens, accounting for 10 million outpatient appointments and 2 million emergency visits annually in the U.S., with an estimated expenditure of \$1.6 billion (Wang & LaSala, 2021).
Additionally, comorbid conditions such as diabetes, chronic kidney disease (CKD), and neurological impairments increase the likelihood of recurrent UTIs. A Kaplan-Meier analysis identified that patients with diabetes, CKD, or frailty indicators per the FRAIL scale were significantly more susceptible to developing UTIs (p < 0.001). A Cox regression model revealed that individuals exhibiting one, two, or three or more FRAIL elements had progressively higher risks — 19%, 24%, and 43% respectively — compared to those without frailty, with risk increasing by 11% for each additional FRAIL factor (Chao et al., 2021).
Additional risk factors include postmenopausal hormonal shifts, incomplete bladder emptying, and urinary incontinence, with prevalence rates of 4.5% for those aged 16–50, 15% for ages 51–70, and 22% in individuals over 70. Patients with type 2 diabetes face heightened UTI risks due to increased bacterial susceptibility within the urinary tract. The anticipated incidence rate for T2D stands at 6,058 per 10,000 individuals, emphasizing its clinical relevance (Bodke et al., 2023). Clinicians should remain vigilant for atypical presentations of UTIs in diabetic patients, promoting timely diagnosis and intervention. Psychosocial challenges, including cognitive decline, depression, and limited healthcare access, also increase vulnerability to unmanaged infections. Chronic outcomes of recurrent UTIs may involve pyelonephritis, antimicrobial resistance, and frequent hospital admissions (Bodke et al., 2023). Early recognition, patient education, and preventive interventions, including prophylactic antibiotics, are fundamental for minimizing complications (Alghoraibi et al., 2023).
To address recurrent UTIs in adult women, the following PICO(T) question was crafted: In adult females with recurrent urinary tract infections (P), how does daily prophylactic antibiotic therapy (I) compared to no prophylaxis or standard care without preventive measures (C) affect recurrence rates and patient outcomes (O) over a 12-month period (T)?
The PICO(T) components are as follows:
This question is structured to assess how preventive antibiotics might reduce infection recurrence and improve overall patient well-being, rather than solely managing episodes reactively (Luchristt et al., 2024).
An extensive literature review was performed using databases such as PubMed, CINAHL, the Cochrane Library, and Google Scholar, with articles evaluated through the CRAAP test to ensure quality and relevance (Kalidas, 2021). Four peer-reviewed articles were chosen to assess prophylactic antibiotic use for recurrent UTIs.
A systematic review by Luchristt et al. (2024) found that a one-month course of antibiotics was more effective in reducing UTI recurrence over 12 months than longer, lower-dose regimens. Published in Urology, the study confirms the value of proactive, short-term antibiotic therapy for recurrent UTI management.
Alghoraibi et al. (2023) conducted a study involving 477 adults, of whom 227 experienced recurrent infections. Continuous prophylaxis, primarily using Nitrofurantoin, Bactrim, or amoxicillin-clavulanic acid, was prescribed to 55% of participants. Bactrim was favored for younger or post-transplant patients, while Nitrofurantoin was common for those with neurogenic bladder or limited mobility. Their results demonstrated significant reductions in infection recurrence, emergency visits, and hospital admissions (P < 0.001).
The American Urological Association (AUA, 2025) guidelines also advocate prophylactic antibiotic use for women with frequent UTIs, reinforcing its position in evidence-based urological care.
Additionally, Liu et al. (2020) reviewed eight randomized controlled trials, concluding that prophylactic antibiotics following urinary catheter removal (within 14 days) lowered infection risks, with a pooled risk ratio of 0.47. The greatest benefits were noted in older patients, those with extended catheter use, and individuals treated with trimethoprim/sulfamethoxazole. This meta-analysis, published in American Journal of Infection Control, underscores the cautious but strategic use of antibiotics in high-risk populations.
Collectively, these studies support the proposed PICO(T) inquiry, revealing that prophylactic antibiotics yield superior outcomes compared to no preventive treatment in women with recurrent UTIs. Persistent infections lead to chronic symptoms and frequent healthcare engagements, while preventive strategies like daily antibiotics reduce recurrence and emergency care requirements (Luchristt et al., 2024). Liu et al. (2020) similarly confirmed the protective effect of continuous antibiotic use. Future investigations should address patient adherence, healthcare access, mental health variables, and individualized care models to optimize management for recurrent UTI cases.
Evidence-informed strategies play a crucial role in managing recurrent UTIs. Care begins with comprehensive clinical assessments to determine infection patterns and severity. This facilitates personalized treatment planning, including the initiation of prophylactic antibiotics for suitable candidates, effectively reducing infection frequency (Alghoraibi et al., 2023).
The next priority involves applying proven interventions such as low-dose, daily antibiotic regimens, shown to minimize recurrence rates and decrease emergency healthcare utilization. Concurrently, educating patients on self-care behaviors—including adequate hydration, symptom monitoring, and medication adherence—empowers them to manage their health proactively (AUA, 2025). These combined efforts not only reduce infection rates but also enhance quality of life and reduce hospital dependency.
This review emphasizes the importance of applying evidence-based prophylactic antibiotic therapies for adult women with recurrent UTIs. Current research validates the effectiveness of preventive antibiotics in lowering infection recurrence rates, reducing healthcare costs, and improving patient experiences. Adopting these measures allows healthcare professionals to minimize infection episodes, reduce hospital visits, and elevate patients’ quality of life.
Alghoraibi, Asidan, A., Aljawaied, Almukhayzim, Alsaydan, Alamer, Baharoon, Masuadi, Shukairi, Layqah, L., & Baharoon. (2023). Recurrent urinary tract infection in adult patients, risk factors, and efficacy of low dose prophylactic antibiotics therapy. Journal of Epidemiology and Global Health, 13(2), 200–211. https://doi.org/10.1007/s44197-023-00105-4
American Urological Association. (2025). Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/CUA/SUFU Guideline (2022) – American Urological Association. Www.auanet.org. https://www.auanet.org/guidelines-and-quality/guidelines/recurrent-uti
Bodke, H., Wagh, V., & Kakar, G. (2023). Diabetes mellitus and prevalence of other comorbid conditions: A systematic review. Cureus, 15(11), e49374. https://doi.org/10.7759/cureus.49374
Bono, M. J., Reygaert, W. C., & Leslie, S. W. (2025). Uncomplicated urinary tract infections. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470195/
Chao, C.-T., Lee, S.-Y., Wang, J., Chien, K.-L., & Huang, J.-W. (2021). Frailty increases the risk for developing urinary tract infection among 79,887 patients with diabetic mellitus and chronic kidney disease. BMC Geriatrics, 21(1), 1–12. https://doi.org/10.1186/s12877-021-02299-3
Kalidas, E. A. J. (2021). The effectiveness of CRAAP test in evaluating credibility of sources. International Journal of TESOL & Education, 1(2), 1-14. https://www.i-jte.org/index.php/journal/article/view/25
Liu, L., Jian, Z., Li, H., & Wang, K. (2020). Antibiotic prophylaxis after extraction of urinary catheter prevents urinary tract infections: A systematic review and meta-analysis. American Journal of Infection Control, 49(2), 247–254. https://doi.org/10.1016/j.ajic.2020.07.034
Luchristt, D., Siddiqui, N. Y., Bruton, Y., & Visco, A. G. (2024). Extended treatment-dose antibiotic therapy versus low-dose prophylaxis for the management of recurrent uncomplicated urinary tract infections in peri- and postmenopausal women. Urology, 198, 29–35. https://doi.org/10.1016/j.urology.2024.12.029
Wang, R., & LaSala, C. (2021). Role of antibiotic resistance in urinary tract infection management: A cost-effectiveness analysis. American Journal of Obstetrics and Gynecology, 225(5), 550.e1–550.e10. https://doi.org/10.1016/j.ajog.2021.08.014
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