HealthDay News — When asked to by their primary health care provider, more than one-third of women with urinary tract infection symptoms were willing to delay antibiotic treatment and most reported spontaneous improvement after one week, study results indicate.

“Although empiric antibiotic treatment of all women with urinary symptoms has been reported to be cost-effective, bacterial resistance is rising and strategies to reduce antibiotic use are needed,” Bart J. Knottnerus, from the University of Amsterdam in the Netherlands, and colleagues reported in BMC Family Practice.

Results from placebo arms of previous randomized trials of women with UTI, have indicated that 25% to 50% of women recover within one week without antibiotics. In order to better understand the proportion of women with UTI symptoms willing to delay antibiotics, Knottnerus and colleagues recruited 176 healthy, non-pregnant women from 20 practices who had contacted their GP with painful and/or frequent micturition for no longer than seven days.

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Urine samples were collected for urinalysis and culture, although without knowing test results, GPs were requested to ask all patients if they were willing to delay antibiotic treatment.

The researchers found that, of the 137 women who were asked by their GP to delay antibiotic treatment, 37% were willing to delay. After seven days, 55% (28/51) of delaying women had not used antibiotics, and 71% (20/28) reported clinical improvement or cure. No women developed pyelonephritis.

“Our results support previous findings that women with UTI symptoms may be more receptive to delayed antibiotic prescriptions than is assumed by many clinicians,” the researchers wrote. “If all of these women were asked to delay antibiotic treatment, antibiotic use might be substantially reduced without negatively impacting clinical recovery.”

One potential strategy, could be to start initial treatment for UTIs with pain medication instead of antibiotics, they suggested.

Study limitations included lack of information about GP and patient attitudes that may influence decisions to delay antibiotics, missing data from the group of patients who said they were not willing to delay antibiotics, and inability to generalize the study results to populations outside of the Netherlands due to cultural differences.


  1. Knotternus BJ et al. BMC Family Practice. 2013;14:71-76.