Capella 4025 Assessment 4

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) represent a common and persistent health issue that significantly impacts adult women. The hallmark symptoms include urinary urgency, painful urination (dysuria), frequency, and suprapubic discomfort. Approximately 41% of women in the United States are expected to develop a UTI during their reproductive years, and nearly 10% face one annually (Bono et al., 2025). The consequences of UTIs extend beyond discomfort—they contribute to repeated healthcare visits, increased financial burden, and a noticeable decline in quality of life. This paper discusses the utility of prophylactic antibiotic therapy as an evidence-based strategy to reduce recurrent UTIs in adult women. The approach aims to inform clinical decisions by evaluating recent data that supports antibiotic prevention as a mechanism for enhancing patient outcomes.

Diagnosis: Prognosis, Potential Risks, and Associated Complications

Recurrent UTIs not only present a discomforting array of symptoms but can also lead to serious health complications such as renal damage and systemic infections like sepsis. Women between the ages of 16 and 35 are at the highest risk, and almost half of those with one UTI will experience a recurrence within a year (Bono et al., 2025). These frequent infections also drive up healthcare costs, with over 10 million medical visits annually in the U.S., and about 2 million emergency department consultations specifically related to UTIs, costing an estimated \$1.6 billion per year (Wang & LaSala, 2021).

Comorbidities such as diabetes, chronic kidney disease (CKD), and neurological disorders significantly elevate the risk of recurrent UTIs. In a large cohort study, frailty indicators (measured by the FRAIL scale) were directly proportional to UTI risk. The presence of one, two, or three frailty symptoms increased the likelihood of UTIs by 19%, 24%, and 43%, respectively, highlighting the compounding effects of chronic illnesses on infection susceptibility (Chao et al., 2021).

Age Group	UTI Prevalence
16–50	4.5%
51–70	15%
70+	22%

Psychosocial aspects also influence recurrence, including cognitive decline, depression, and poor access to healthcare, which collectively lead to unmanaged symptoms and repeated hospital admissions. In patients with Type 2 Diabetes (T2D), urinary systems are often more vulnerable due to immunosuppression and increased glucose in urine, contributing to higher bacterial colonization rates (Bodke et al., 2023). The estimated T2D incidence rate is 6,058 per 10,000 individuals, further underscoring the clinical significance of this comorbidity.

Without timely intervention, recurrent UTIs can progress from minor symptoms to advanced complications such as pyelonephritis and antibiotic resistance. One illustrative example is a patient initially presenting with simple urinary discomfort, who progresses to severe renal dysfunction due to lack of preventive care. Prophylactic antibiotic therapy, alongside education and early detection, is essential in managing such risks effectively (Alghoraibi et al., 2023).

Formulating the Research Question

To investigate the effectiveness of antibiotic prevention in reducing recurrent UTIs among women, a PICO(T) research question was developed:

PICO(T) Question: In adult females with repeated UTIs (P), how does the daily use of prophylactic antibiotics (I) compared to no prophylaxis or standard care (C) affect recurrence rates and patient outcomes (O) over a period of 12 months (T)?

This question aligns with each component of the PICO(T) model:

PICO(T) Component	Definition
Population (P)	Adult females with recurrent UTIs
Intervention (I)	Daily prophylactic antibiotic therapy
Comparison (C)	No antibiotic prophylaxis or standard care
Outcome (O)	Reduction in recurrence rate and improved patient outcomes
Timeframe (T)	12-month observation period

Adult women experiencing frequent UTIs often endure diminished quality of life and multiple healthcare visits. The chosen intervention—prophylactic antibiotics—focuses on prevention rather than reactionary treatment. According to Luchristt et al. (2024), preventive antibiotics such as low-dose nitrofurantoin can significantly lower recurrence rates. Comparatively, standard care addresses UTIs only after onset. The outcome aims to reduce emergency visits and improve daily functioning. A year-long timeframe allows for a comprehensive evaluation of the intervention’s durability and safety, ensuring evidence-based clinical decisions.

Summary of Evidence from Peer-Reviewed Sources

An extensive review of academic literature reveals a strong case for prophylactic antibiotic use in preventing recurrent UTIs among women. Sources were selected based on CRAAP criteria—Currency, Relevance, Authority, Accuracy, and Purpose (Kalidas, 2021)—and included peer-reviewed journals and established clinical guidelines.

Study/Source	Key Findings
Luchristt et al. (2024)	One-month antibiotic plans showed better long-term results than ≥3-month regimens; prophylaxis reduced recurrence.
Alghoraibi et al. (2023)	Prophylactic antibiotics (e.g., Bactrim, Nitrofurantoin) decreased UTI recurrence, ER visits, and hospitalizations.
American Urological Association (2025)	Guidelines endorse antibiotic prophylaxis for women with frequent uncomplicated UTIs.
Liu et al. (2020)	Post-catheter prophylaxis reduced UTIs by 53%; especially effective for those over 60 and with catheters >5 days.

These sources illustrate that prophylactic antibiotics not only reduce infection recurrence but also improve the overall health burden by limiting hospital utilization. While antibiotic overuse remains a concern, individualized risk assessment and targeted prophylaxis for high-risk populations offer a balanced strategy.

Evidence-Based Response to the PICO(T) Question

Findings from the reviewed literature support the PICO(T) question, indicating that prophylactic antibiotics are beneficial for women with frequent UTIs. Luchristt et al. (2024) showed that short-course antibiotic regimens are both effective and well-tolerated. Liu et al. (2020) supported these outcomes through meta-analyses involving catheter-related infections, a high-risk category often overlapping with recurrent UTI patients. These insights validate that preventive antibiotics can reduce symptomatic episodes and avoid complications like sepsis and kidney infections.

However, success hinges on certain assumptions: adherence to daily regimens, patient education, and healthcare providers’ capability to adjust medications based on response and resistance patterns. Socioeconomic status, comorbidities, and mental health must also be considered, as they influence adherence and access to consistent care.

Essential Care Steps Guided by Evidence-Based Recommendations

Implementing a stepwise, evidence-based care pathway can drastically reduce recurrent UTI rates. First, thorough assessments are necessary to identify high-risk individuals and stratify them based on frequency and severity. This supports personalized therapeutic decisions.

Next, clinicians should consider initiating low-dose antibiotic prophylaxis for patients fitting eligibility criteria. Alghoraibi et al. (2023) demonstrated that patients receiving tailored regimens—based on mobility, neurological status, or surgical history—experienced fewer recurrences.

The final and equally important step involves patient education. Empowering patients to recognize early symptoms, maintain hydration, and adhere to medications improves long-term outcomes. As the AUA (2025) emphasized, education significantly enhances adherence and self-management, reducing recurrence and the need for acute interventions.

Care Step	Action
Assessment	Evaluate history, frequency, and comorbidities
Intervention	Initiate prophylaxis based on risk profile
Patient Education	Instruct on hydration, hygiene, and medication adherence

Conclusion

The investigation underscores the importance of adopting evidence-based strategies such as prophylactic antibiotic therapy to manage recurrent UTIs among adult women. By reducing infection recurrence, improving quality of life, and minimizing emergency department visits, preventive antibiotic regimens prove to be a cost-effective and clinically sound approach. Ongoing research should further refine patient-specific treatment plans to optimize care delivery.

References

Alghoraibi, A., Aljawaied, A., Almukhayzim, A., Alsaydan, B., Alamer, M., Baharoon, S., Masuadi, E., Shukairi, L., 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. 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

Capella 4025 Assessment 4

Bono, M. J., Reygaert, W. C., & Leslie, S. W. (2025). Uncomplicated urinary tract infections. StatPearls. 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 diabetes 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