Capella 4025 Assessment 4

Capella 4025 Assessment 4

Student Name

Capella University

NURS-FPX4025 Research and Evidence-Based Decision Making

Prof. Name

Date

Presenting Your PICO(T) Process Findings to Your Professional Peers

Urinary tract infections (UTIs) are a prevalent and distressing condition, especially among women. These infections commonly present with symptoms such as frequent urination, pain during urination, urgency, and suprapubic discomfort. They result in multiple healthcare visits and significantly affect patients’ quality of life. Statistically, nearly 41% of women in the United States are expected to develop a UTI at some point in their lives, with around 10% encountering one each year (Bono et al., 2025). To reduce the recurrence of UTIs and the burden on healthcare systems, effective and evidence-based strategies are needed. This presentation highlights the use of prophylactic antibiotic therapy as a preventive measure in reproductive-aged women who suffer from recurrent UTIs.

Diagnosis: Prognosis, Potential Risks, and Associated Complications

UTIs can result in a wide range of health complications if left untreated or improperly managed. Adult women are particularly vulnerable, with recurrent infections increasing the risk of serious issues such as kidney infections and sepsis. The symptoms, including dysuria, urgency, and sometimes fever, can progress into more complex conditions like pyelonephritis or chronic renal problems (Bono et al., 2025). A significant concern is hospital readmission, which often arises due to recurring infections and insufficient initial treatment.

Risk factors such as age, hormonal changes, incomplete bladder emptying, and urinary incontinence increase susceptibility. Nearly half of women who experience one UTI will have another within the next year (Bono et al., 2025). Moreover, certain comorbidities—such as diabetes, chronic kidney disease (CKD), and frailty—heighten the probability of recurrent UTIs. Chao et al. (2021) found that individuals with higher frailty scores, based on the FRAIL scale, demonstrated significantly increased UTI risk. The hazard ratios rose consistently with each added frailty item.

Table 1: Influence of Comorbidities on UTI Recurrence (Chao et al., 2021)

FRAIL Items Present	Increased Hazard Ratio for UTI
0	Reference (baseline)
1	19% increase
2	24% increase
3 or more	43% increase
Each additional item	11% increase per item

Age also plays a significant role in prevalence rates. For example, 4.5% of individuals aged 16–50 are affected, compared to 22% in those over 70 (Bodke et al., 2023). The prevalence is notably higher among patients with type 2 diabetes due to compromised immune responses, with an incidence rate of 6,058 per 10,000 persons. In these populations, UTIs often go undetected until complications arise, especially when psychosocial barriers like depression or limited healthcare access exist. Preventive strategies, including prophylactic antibiotics and patient education, become essential in mitigating these risks (Alghoraibi et al., 2023).

Formulating the Research Question

To evaluate the impact of preventive treatment on recurrent UTIs in women, a structured PICO(T) question was formulated: In adult females with repeated UTIs (P), how does the practice of daily prophylactic antibiotics (I) compared to no prophylaxis or standard care without preventive treatment (C) affect the recurrence rate and patient outcomes (O) over 12 months (T)?

This question supports the clinical evaluation of long-term treatment benefits. Each element of the PICO(T) model is clearly represented:

Table 2: PICO(T) Framework for Recurrent UTI Intervention

Component	Definition
Population (P)	Adult women experiencing recurrent UTIs
Intervention (I)	Daily use of prophylactic antibiotics
Comparison (C)	No prophylaxis or standard symptomatic treatment
Outcome (O)	Reduction in recurrence rate; improved quality of life and fewer hospital visits
Time (T)	12-month evaluation period

This structure supports a focused investigation into whether daily low-dose antibiotic regimens can effectively prevent recurrent UTIs. Luchristt et al. (2024) found this approach significantly decreased UTI recurrence rates over a one-year period. This comparison between proactive and reactive treatments allows for data-driven improvements in clinical practice.

Summary of Evidence from Peer-Reviewed Sources

A thorough literature review was conducted using databases such as PubMed, CINAHL, the Cochrane Library, and Google Scholar. Selection was guided by the CRAAP criteria to ensure the quality and reliability of sources (Kalidas, 2021). The following sources offer a well-rounded view of the efficacy and outcomes of prophylactic antibiotic use in managing recurrent UTIs:

• Luchristt et al. (2024) performed a comparative analysis between one-month and three-month prophylactic antibiotic regimens in perimenopausal and postmenopausal women. The study concluded that shorter but targeted treatments were more effective in reducing recurrence within 12 months.
• Alghoraibi et al. (2023) examined 477 adult patients, noting that continuous use of antibiotics like Nitrofurantoin or Bactrim significantly reduced ER visits and hospitalizations. Results were especially beneficial for post-transplant and urologic surgery patients.
• Liu et al. (2020) conducted a meta-analysis involving randomized controlled trials, concluding that antibiotic prophylaxis following urinary catheter removal decreased UTI risk by 53% (RR = 0.47), particularly in older adults and those with longer catheterization.
• AUA Guidelines (2025) support the use of prophylactic antibiotics in women with frequent UTIs. These recommendations are backed by clinical consensus and reinforce the importance of individualized care in recurrent infection prevention.

Evidence-Based Response to the PICO(T) Question

The collective findings of recent studies strongly support the effectiveness of prophylactic antibiotic therapy in reducing the frequency and impact of recurrent UTIs in women. Patients on daily low-dose antibiotics reported fewer infections, lower hospitalization rates, and improved daily functioning (Luchristt et al., 2024). Liu et al. (2020) further validated these findings in populations with temporary urinary catheters, recommending preventive treatment especially for older adults and those with prolonged catheter use.

Successful outcomes depend on several variables, including patient compliance, healthcare access, and the ability of clinicians to tailor treatments based on individual risk profiles. Psychological and socioeconomic factors such as depression and low healthcare literacy may limit the effectiveness of interventions if not adequately addressed. Future research should focus on personalized care models that consider comorbidities, age, and behavioral health in treatment planning.

Essential Care Steps Guided by Evidence-Based Recommendations

Implementing evidence-based strategies involves several clinical steps that help reduce recurrence and improve outcomes:

1. Initial Assessment: Evaluate UTI frequency, risk factors, and symptom severity to identify suitable candidates for long-term preventive therapy.
2. Targeted Intervention: Prescribe low-dose, daily antibiotics such as Nitrofurantoin based on individual patient profiles. Evidence shows this approach lowers infection rates and reduces healthcare utilization (Alghoraibi et al., 2023).
3. Patient Education: Engage patients through counseling on hydration, hygiene, medication adherence, and symptom monitoring. Education improves compliance and empowers patients to participate actively in their care (AUA, 2025).

These three phases—assessment, treatment, and education—form the foundation of a sustainable, evidence-based approach to managing recurrent UTIs.

Conclusion

This review demonstrates the value of evidence-based prophylactic antibiotic therapy in addressing recurrent urinary tract infections in adult women. Preventive treatments significantly reduce recurrence rates, lower the need for emergency medical services, and enhance patients’ quality of life. By applying structured, data-driven strategies, clinicians can effectively manage this common but complex condition. Future efforts should prioritize personalization of treatment plans, early risk detection, and ongoing patient education to ensure optimal long-term outcomes.

References

Alghoraibi, A., Aljawaied, A., Almukhayzim, N., Alsaydan, M., Alamer, Y., Baharoon, S., Masuadi, E., Shukairi, H., Layqah, L., & Baharoon, D. (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. https://www.auanet.org/guidelines-and-quality/guidelines/recurrent-uti

Capella 4025 Assessment 4

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. In StatPearls. National Library of Medicine. 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

Capella 4025 Assessment 4

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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