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You can find the current article at its original source at https://www.theguardian.com/society/2019/oct/07/antibiotics-better-tests-and-the-rise-in-cases-of-urinary-tract-infections
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| Antibiotics, better tests and the rise in cases of urinary tract infections | Antibiotics, better tests and the rise in cases of urinary tract infections |
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| I read your article (Antibiotic crackdown linked to big rise in women ending up in hospital with cystitis, 5 October) with great interest. I am a fit, single 85-year-old with a penchant for international travel. Fifteen years ago I was diagnosed with interstitial cystitis and very satisfactorily treated with the antibiotic trimethoprim. | I read your article (Antibiotic crackdown linked to big rise in women ending up in hospital with cystitis, 5 October) with great interest. I am a fit, single 85-year-old with a penchant for international travel. Fifteen years ago I was diagnosed with interstitial cystitis and very satisfactorily treated with the antibiotic trimethoprim. |
| My GP retired and another GP set about reviewing this drug, saying that it could no longer be effective. I suffered infections, confirmed by dipstick tests and lab reports, at times being seriously mentally affected, and had difficulty getting appointments to facilitate the planned three-monthly drug rotation, a particular worry for my travel plans. I could so easily have also ended up in hospital. | My GP retired and another GP set about reviewing this drug, saying that it could no longer be effective. I suffered infections, confirmed by dipstick tests and lab reports, at times being seriously mentally affected, and had difficulty getting appointments to facilitate the planned three-monthly drug rotation, a particular worry for my travel plans. I could so easily have also ended up in hospital. |
| Miracle of miracles, this week the trimethoprim has been reinstated. What a relief.Audrey GrayPulborough, West Sussex | Miracle of miracles, this week the trimethoprim has been reinstated. What a relief.Audrey GrayPulborough, West Sussex |
| • Proven urinary tract infections (UTIs) must be treated with the relevant antibiotic as reported by the lab microscopy, or the infection will rise to the kidneys. This can be life-threatening. The rise in numbers of UTIs is due to poor hygiene in the increasing numbers of older people, often chair-bound and with very limited mobility, preventing efficient washing to limit bacterial travel. | • Proven urinary tract infections (UTIs) must be treated with the relevant antibiotic as reported by the lab microscopy, or the infection will rise to the kidneys. This can be life-threatening. The rise in numbers of UTIs is due to poor hygiene in the increasing numbers of older people, often chair-bound and with very limited mobility, preventing efficient washing to limit bacterial travel. |
| In younger women where today’s sexual climate is much less inhibited, little effort is made to prevent bacterial travel before intercourse. My books and 40 years of teaching show how the presence of simple daily prevention can stop a lifetime of suffering. | In younger women where today’s sexual climate is much less inhibited, little effort is made to prevent bacterial travel before intercourse. My books and 40 years of teaching show how the presence of simple daily prevention can stop a lifetime of suffering. |
| But prevention is neither taught at home, in school hygiene classes, in nurses’ training courses nor in medical schools.The Qur’an is helpful to men and women in the regular practising of hygiene, but the Bible isn’t. Neither Muslims nor Hindus experience the same levels of infection as western women do. The million-dollar question “why do some women get this infection often and some do not?” is down to the different lengths of perianal female geography.Angela KilmartinAuthor, The Patient’s Encyclopaedia of Urinary Tract Infection, Sexual Cystitis and Interstitial Cystitis | |
| • How frustrating to read this article, with contributions from medics who have failed to highlight the need for accurate midstream urine collection. Every guideline in the world specifies midstream as the most reliable sample for accurate analysis, diagnosis and treatment of UTI. Yet the matter is persistently overlooked because changing this means changing hearts, minds, attitudes and the relevant patient pathway. What a faff for established systems. My company has data from an FOI request to all NHS trusts in 2016; this revealed national urine contamination rates that varied from below 1% to over 70%, with an average 23.5%; that’s over 16m patients a year who will not be properly diagnosed and treated from their urine sample. If this lack of accuracy was endemic in blood analysis there would rightly be a national outcry. Urine, as a waste product, is not given the same respect, despite being a window to our health. | • How frustrating to read this article, with contributions from medics who have failed to highlight the need for accurate midstream urine collection. Every guideline in the world specifies midstream as the most reliable sample for accurate analysis, diagnosis and treatment of UTI. Yet the matter is persistently overlooked because changing this means changing hearts, minds, attitudes and the relevant patient pathway. What a faff for established systems. My company has data from an FOI request to all NHS trusts in 2016; this revealed national urine contamination rates that varied from below 1% to over 70%, with an average 23.5%; that’s over 16m patients a year who will not be properly diagnosed and treated from their urine sample. If this lack of accuracy was endemic in blood analysis there would rightly be a national outcry. Urine, as a waste product, is not given the same respect, despite being a window to our health. |
| Thanks to a now retired NHS GP, there is a way to get this right: in 2001 Dr Vincent Forte invented an NHS award-winning midstream urine device that now costs the NHS less than 90p; growing evidence confirms that his invention reduces contamination to 1.5% and false positives by up to 70%. These benefits lead to reduced unnecessary prescribing because patients can be treated with targeted antibiotics for the appropriate duration, not the broad spectrum variety believed to encourage antimicrobial resistance (AMR). What does this mean? It means properly treated conditions, healthy patients and huge savings on retests, repeat appointments and more for the NHS itself. | Thanks to a now retired NHS GP, there is a way to get this right: in 2001 Dr Vincent Forte invented an NHS award-winning midstream urine device that now costs the NHS less than 90p; growing evidence confirms that his invention reduces contamination to 1.5% and false positives by up to 70%. These benefits lead to reduced unnecessary prescribing because patients can be treated with targeted antibiotics for the appropriate duration, not the broad spectrum variety believed to encourage antimicrobial resistance (AMR). What does this mean? It means properly treated conditions, healthy patients and huge savings on retests, repeat appointments and more for the NHS itself. |
| Women must not feel that reduced prescribing due to AMR is preventing their treatment, but understand that until the medical profession gets the basics right, treatment itself will remain unreliable. Fifteen years after Dr Forte invented the British-made Peezy Midstream, after much development, trials and investment it is now being used in some NHS antenatal clinics. But much like the variation in contamination data mentioned above, until it is adopted for all urine collection, successful urine screening will remain a national lottery. | Women must not feel that reduced prescribing due to AMR is preventing their treatment, but understand that until the medical profession gets the basics right, treatment itself will remain unreliable. Fifteen years after Dr Forte invented the British-made Peezy Midstream, after much development, trials and investment it is now being used in some NHS antenatal clinics. But much like the variation in contamination data mentioned above, until it is adopted for all urine collection, successful urine screening will remain a national lottery. |
| Meanwhile, the only beneficiaries of failed UTI treatment are the pharmaceutical industry and the labs that are compensated (by the NHS) per sample; right-first-time, prompt, targeted treatment is of no interest to either party. Unfortunately their voices are louder than those of patients in pain.Giovanna ForteCEO, Forte Medical | Meanwhile, the only beneficiaries of failed UTI treatment are the pharmaceutical industry and the labs that are compensated (by the NHS) per sample; right-first-time, prompt, targeted treatment is of no interest to either party. Unfortunately their voices are louder than those of patients in pain.Giovanna ForteCEO, Forte Medical |
| • Methenamine hippurate, which is a cheap, effective drug used for urinary tract infections, has been unavailable for many months. I know of two people who have died of sepsis as a consequence of this drug not being available to them. I also am badly affected. It seems to be because this affects mostly women in old age – I am in my 80s – and therefore this matter is not taken seriously. | • Methenamine hippurate, which is a cheap, effective drug used for urinary tract infections, has been unavailable for many months. I know of two people who have died of sepsis as a consequence of this drug not being available to them. I also am badly affected. It seems to be because this affects mostly women in old age – I am in my 80s – and therefore this matter is not taken seriously. |
| It is, in my opinion, another national scandal. Why on earth does the NHS not manufacture its own cheap drugs? It would improve availability, and reduce costs.Jean CrowdenHett, County Durham | It is, in my opinion, another national scandal. Why on earth does the NHS not manufacture its own cheap drugs? It would improve availability, and reduce costs.Jean CrowdenHett, County Durham |
| • My daughter has experienced 20 years of pain, suffering and humiliation and over-reliance on urine test results. She has barely left the house for months due to intense pain and weakness despite the best efforts of a devoted GP. These infections require more research, a new protocol and Nice guidelines for chronic cases to prevent more lives being destroyed.Name and address supplied | • My daughter has experienced 20 years of pain, suffering and humiliation and over-reliance on urine test results. She has barely left the house for months due to intense pain and weakness despite the best efforts of a devoted GP. These infections require more research, a new protocol and Nice guidelines for chronic cases to prevent more lives being destroyed.Name and address supplied |
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