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PICOT UTI

probiotics and antibiotics better for UTI management

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PICOT UTI

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  1. PICOT  FRAMWORK  ANNUAL MASSACHUSETTS U.T.I Chantalacia Swaby Capella University NURS-FPX4025 - Research and Evidence-Based Decision Making Dr. Amanda Zemmer Sept 2025

  2. Explaining A Diagnosis UTIs is bacterial invasion of the urinary tract which starts at the urethra and may move up to the bladder and kidneys as the infection progresses , with Escherichia coli being the most common pathogen responsible for these infections. This disease is common among female affect of over 50% of the 400 million affected yearly This disease is common among female affect of over 50% of the 400 million affected yearly. Symptoms Contributing Factors Symptoms may include dysuria, fever ,pelvic pain ,frequency , hematuria as well as sudden onset confusion and falls in the elderly. Poorly managed diabetes pregnancy. Douching and use of spermicides Menopause Complications and Vulnerable Groups Complications include recurring UTIs that are further exacerbated by unhealthy eating habits and the chronic use of antibiotics. Vulnerable populations such as the homeless ,elderly, minority and marginalized are at risk for recurrences .UTIs may progress to , pyelonephritis and sepsis due to financial constraints and unequal access to health. They are not able to see preventive care and follow up as they ought to resulting in adverse outcomes

  3. RESEARCH QUESTION USING PICO(T) CRITERIA IN ADULT WOMEN DIAGNOSED WITH UTI (P) ,HOW DOES A STRUCTURED APPROACH INCORPORATE ANTIBIOTICS, PROBIOTICS AND SUPPLEMENTS (I), (C) COMPARED TO STANDARD APPROACH USE OF ANTIBIOTICS, AFFECT THE RATE OF UTI RECURRENCE AND RE-DUCES ANTIBIOTIC RESISTANCE (O) WITHIN SIX MONTHS (T)

  4. KEY STEPS OF CARE Consisting Follow ups Individualized Plan of care Patient Assessment Collect patient Medical history Lifestyle and dietary practices. Cultural beliefs Socio economic status Support system eg Faimily Assess for barrier and readiness to engage . Monitor patient's progress, and address challenges. by scheduling follow-ups at one, three, and six months . Encourages patient adherence and make changes as needed. Implement a structured treatment plan such as adding probiotics such as Lactobacilli to standard antibiotics e.g. Macrobid as more effective treatment for UTIs

  5. KEY STEPS OF CARE  Structured Framework • Use evidence-based models like Iowa EBP to guide the implementation of research-based changes into practice systematically. Such as this new adjunctive UTI treatment approach. Patient Education Assess for language barrier  02 Educate  patients on medication compliance , Side effect and interactions  Help patient make connections between gut health and UTIs. 03 Collaborative care • Engage multidisciplinary professionals, including Nurses, Dietitian , Obstetrician-Gynecologist (OB-GYN), Urologist Primary care providers. To ensure coordination  and more comprehensive care to improve outcomes.

  6. SUMMARY OF SOURCES  Dysbiosis and UTI Iowa-Evidenced based Practice Model Randomized double-blind placebo-controlled study Article emphasized the role of model such as these in guiding the implementation of changes within clinical practice. Connected dysbiosis and the overgrowth unhealthy bacteria and antibiotic resistance to increase rates in UTI recurrence as well as a lack of knowledge about probiotic use and its benefits. This study found value in adding multi strain lactobacilli probiotic to a standard antibiotic in 75% of the 51 women versus the placebo group in managing UTI.

  7. ANSWER TO THE PICO(T) QUESTION BASED ON EVIDENCE  Based on the  evidence it has been proven  that adjunctive approaches such as the combination of probiotics ,supplements to antibiotics are significantly more effective than standard treatments of antibiotics alone for treatment UTIs . This combination has a more sustained effect on reducing antibiotic resistance and recurrence rates. (Ruța et al.,2024; Mirsha et al., 2024)

  8. By utilizing adjunctive measures such as these, medicals practitioners can improve the quality of life for many people across the globe through more effective health care delivery and management of UTI. CONCLUSION     UTIs is bacterial invasion of the urinary tract that is prevalent in 50% of women out of 400 million.  The high prevalence rate of UTI underscores it significant UTI places on individual and health are system Standard treatment in place alone is not enough to effectively treat UTIs  because persistent recurrence  continues to be a great challenge for many especially the underserved. Scientific research supports the use of standard antibiotic regimen combined with probiotics as an alternative in a bid to reduce recurrence rate and fix hospital recidivism. This approach leads to better quality of life , lower expenditure and less time at doctors visits. 

  9. Reference Baimakhanova, B., Sadanov, A., Trenozhnikova, L., Balgimbaeva, A., Baimakhanova, G., Orasymbet, S., Tleubekova, D., Amangeldi, A., Turlybaeva, Z., Nurgaliyeva, Z., Seisebayeva, R., Kozhekenova, Z., Sairankyzy, S., Shynykul, Z., Yerkenova, S., & Turgumbayeva, A. (2025). Understanding the burden and management of urinary tract infections in Women. Diseases, 13(2), 59. https://doi.org/10.3390/diseases13020059 McClinton, T. D. (2022). A guided search: Formulating a PICOT from assigned areas of inquiry. Worldviews on Evidence- Based Nursing, 19(5), 426–427. https://doi.org/10.1111/wvn.12598 Mishra, A., Jena, S. K., Srinivasan, A., Tripathy, A., Rituparna Maiti, & Hota, D. (2024). Effect of an add-On multi-strain probiotic formulation in the prevention of recurrent urinary tract infections: A double-blind randomized placebo-controlled trial. Microbiology Research, 15(4), 2330–2340. https://doi.org/10.3390/microbiolres15040156 Newlands, A. F., Roberts, L., Maxwell, K., Kramer, M., Price, J. L., & Finlay, K. A. (2023, January 17). The recurrent urinary tract infection symptom scale: Development and validation of a patient-reported outcome measure. BJUI compass. https://pmc.ncbi.nlm.nih.gov/articles/PMC10071086/ Ruța, F., Pribac, M., Mardale, E., Suciu, S., Maior, R., Bogdan, S., & Avram, C. (2024, June 3). Associations between gut microbiota dysbiosis and other risk factors in women with a history of urinary tract infections. Nutrients. https://pmc.ncbi.nlm.nih.gov/articles/PMC11174854/ Santa, K., Boda, Z., Kara, B., Huber, J., Catt, H., & Mezes, B. (2025, March 17). Collaborative networks in community-based health and Social Care Services: Insights from Blackpool and the Fylde Coast (United Kingdom) - health research policy and systems. BioMed Central. https://health-policy-systems.biomedcentral.com/articles/10.1186/s12961-025-01303-1 Tucker, S., McNett, M., Melnyk, B. M., Hanrahan, K., Hunter, S. C., Kim, B., Cullen, L., & Kitson, A. (2021). Implementation Science: Application of evidence‐based practice models to improve

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