New approach to UTI treatment tested
An NHS-backed research programme is testing whether switching antibiotics to treat urinary tract infections (UTIs) can help tackle rising antimicrobial resistance.
The IPAP-UTI programme, led by the University of Bristol, is running randomised controlled trials (RCTs) across regions of England where resistance to commonly used UTI treatments is particularly high.
The trials will test whether updating prescribing guidance, offering clinician training and adding prescribing prompts to GP systems can reduce resistance to specific antibiotics by promoting recommended alternatives.
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The programme is being run in partnership with Integrated Care Boards and the UK Health Security Agency (UKHSA), which is providing anonymised data from participating practices to monitor changes in prescribing and resistance rates.
The first two trials are already underway in West Yorkshire and Kent and Medway.
Participating GP practices are randomly assigned to either an intervention group – which receives support to change prescribing behaviour – or a control group continuing with usual care.
Researchers will assess whether the intervention reduces resistance to the targeted antibiotics, improves treatment success rates, and affects hospital admissions or emergency care linked to UTIs and sepsis.
Costs will also be analysed to determine affordability and value for the NHS.
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The project builds on previous shifts in prescribing – such as the move from trimethoprim to nitrofurantoin – which may have helped in some areas but raised concerns about unintended consequences elsewhere.
If successful, the study could lead to updated national guidelines, providing clinicians with stronger evidence to choose effective antibiotics and helping preserve their usefulness in the future.
The research will be published in peer-reviewed journals, presented at conferences, and shared with regulators and stakeholders.
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UTIs are among the most common infections treated in primary care, but rising resistance means many first-line antibiotics are becoming less effective.
Up to 50% of UTI-causing bacteria are now resistant to at least one antibiotic, according to the UKHSA.
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