Podcast
Questions and Answers
Who is the lead commissioner for the PGD concerning Nitrofurantoin for urinary tract infections in the North East North Cumbria region?
Who is the lead commissioner for the PGD concerning Nitrofurantoin for urinary tract infections in the North East North Cumbria region?
- Newcastle Gateshead CCG (correct)
- North-East & Yorkshire Regional Antimicrobial Stewardship
- Head of Services & Support for North of Tyne Local Pharmaceutical Committee
- North East and North Cumbria Integrated Care Board
What is the expiry date of the PGD for the supply of Nitrofurantoin?
What is the expiry date of the PGD for the supply of Nitrofurantoin?
- 01 03 2023
- 01 09 2023
- 31 03 2022
- 31 03 2024 (correct)
Which professional's signature is the last to be obtained on the PGD for Nitrofurantoin?
Which professional's signature is the last to be obtained on the PGD for Nitrofurantoin?
- Prof Philip Howard OBE
- Dr Janet Walker (correct)
- Ann Gunning
- Dr Dominic Slowie
What is the review date for the PGD concerning Nitrofurantoin?
What is the review date for the PGD concerning Nitrofurantoin?
Which role is associated with Ann Gunning in the context of the PGD?
Which role is associated with Ann Gunning in the context of the PGD?
What age group does the PGD for Nitrofurantoin target for urinary tract infections?
What age group does the PGD for Nitrofurantoin target for urinary tract infections?
What is the main objective of care for treating uncomplicated lower urinary tract infections in women aged 16 to 64 years?
What is the main objective of care for treating uncomplicated lower urinary tract infections in women aged 16 to 64 years?
Who is the Regional Antimicrobial Stewardship Lead mentioned in the PGD?
Who is the Regional Antimicrobial Stewardship Lead mentioned in the PGD?
Which symptom is NOT part of the key diagnostic signs for uncomplicated lower urinary tract infections?
Which symptom is NOT part of the key diagnostic signs for uncomplicated lower urinary tract infections?
Which date marks the beginning of validity for the PGD concerning Nitrofurantoin?
Which date marks the beginning of validity for the PGD concerning Nitrofurantoin?
What diagnostic outcome is required alongside having two or more key urinary symptoms for treatment eligibility?
What diagnostic outcome is required alongside having two or more key urinary symptoms for treatment eligibility?
Which of the following is NOT an exclusion criterion for treatment of urinary tract infections?
Which of the following is NOT an exclusion criterion for treatment of urinary tract infections?
What age group is ineligible for treatment under the guidelines specified?
What age group is ineligible for treatment under the guidelines specified?
Which of the following patients should be referred immediately if pyelonephritis is suspected?
Which of the following patients should be referred immediately if pyelonephritis is suspected?
Which condition is an exclusion for treatment due to potential complications?
Which condition is an exclusion for treatment due to potential complications?
In which situation could a patient still be treated despite recent complaints?
In which situation could a patient still be treated despite recent complaints?
Flashcards
Uncomplicated Lower Urinary Tract Infection (UTI) in Women
Uncomplicated Lower Urinary Tract Infection (UTI) in Women
A urinary tract infection affecting the bladder and urethra, primarily impacting women between 16 and 64 years old, characterized by common symptoms such as burning urination, frequent urination, especially at night, urgency, and visible blood in the urine.
Key Diagnostic Signs of Uncomplicated UTI
Key Diagnostic Signs of Uncomplicated UTI
Diagnostic signs like burning urination, frequent urination, especially at night, urgency, needing to pee often, visible blood in the urine, and a positive dipstick test for nitrites.
Dipstick Test for Nitrites
Dipstick Test for Nitrites
A test strip used to detect nitrites in urine, indicating the potential presence of bacteria associated with UTIs.
Exclusion Criteria for Uncomplicated UTI Treatment
Exclusion Criteria for Uncomplicated UTI Treatment
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Potential Signs of Pyelonephritis
Potential Signs of Pyelonephritis
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Excluded Causes of Urinary Symptoms Other Than UTIs
Excluded Causes of Urinary Symptoms Other Than UTIs
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Recent UTI Treatment and Recurring Infections
Recent UTI Treatment and Recurring Infections
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Specific Conditions Excluded from PGD Treatment
Specific Conditions Excluded from PGD Treatment
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What is a Patient Group Direction (PGD)?
What is a Patient Group Direction (PGD)?
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What is the purpose of a PGD?
What is the purpose of a PGD?
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What are the eligibility criteria for using a PGD?
What are the eligibility criteria for using a PGD?
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Who is authorized to work according to a PGD?
Who is authorized to work according to a PGD?
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What important information is included in a PGD?
What important information is included in a PGD?
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Who is responsible for approving a PGD?
Who is responsible for approving a PGD?
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What is the specific PGD mentioned in the content?
What is the specific PGD mentioned in the content?
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What is the validity period of the PGD?
What is the validity period of the PGD?
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Study Notes
Patient Group Direction (PGD) for Nitrofurantoin
- Purpose: Supply of nitrofurantoin for uncomplicated urinary tract infections (UTIs) in females aged 16-64 years.
- Lead Commissioner: Newcastle Gateshead CCG.
- Direction Number: PGD-03
- Valid from: 01 March 2022
- Review date: 01 September 2023
- Expiry date: 31 March 2024
Development and Production
- Head of Services & Support (North of Tyne Local Pharmaceutical Committee): Ann Gunning
- Regional Antimicrobial Stewardship Lead (North-East & Yorkshire Region): Prof Philip Howard OBE
- Medical Director (Newcastle Gateshead CCG): Dr Dominic Slowie
- Date developed/produced: 31 March 2022
PGD Approval
- Medical Director (NENC ICB): Dr Janet Walker
- Director of Medicines and Pharmacy (NENC ICB): Ewan Maule
- Date approved for use in NENC ICB: 12 June 2023
- Organisation: North East and North Cumbria Integrated Care Board
Inclusion Criteria
- Healthy, non-pregnant women: Aged 16-64 years.
- Presenting with: Two or more of the five key diagnostic signs/urinary symptoms: dysuria, nocturia, urgency, frequency, visible haematuria, and positive dipstick test for nitrites (refer to current SPC for detail).
Exclusion Criteria
- Only one key diagnostic symptom:
- Two or more symptoms + negative dipstick test:
- Male:
- Under 16 years of age:
- Age 65+:
- Immunocompromised/complex multiple morbidity:
- Currently taking oral antibiotics:
- Suspected pyelonephritis or sepsis:
- Kidney pain/tenderness/myalgia/influenza-like illness:
- Fever (37.9°C or higher):
- Nausea and vomiting:
- Confusion(elderly):
- Known hypersensitivity to nitrofurantoin:
- Vaginal or urethral causes of urinary symptoms:
Treatment Details
- Drug Name: Nitrofurantoin
- Strength & Formulation: MR 100mg capsules, 50mg tablets
- Legal Status: Prescription Only Medicine (POM)
- Dosage/Dose Range: First line: 100mg capsules twice daily for 3 days with food. Second line: 50mg tablets four times daily for 3 days with food.
- Route: Oral
- Frequency: Single course of 3 days treatment for each infection.
Follow-up Treatment
- Patient deterioration: Seek immediate medical attention.
- Systemic illness: Seek immediate medical attention.
- Little improvement after 3 days: Seek medical attention.
- Side effects: Advise patient to stop taking medication and contact medical practitioner immediately if rash, hypersensitivity, or side effects appear.
Adverse Reactions
- Mild and reversible: Nausea, vomiting, pruritus, skin rashes.
- Potentially severe: Acute pulmonary reactions, neurological effects (peripheral neuropathy), severe allergic skin reactions (erythema multiforme), haematological effects.
Reporting Adverse Reactions
- Serious adverse reactions: Report to MHRA via Yellow Card system.
Patient/Carer Information
Referral to Medical Advice
Records
Additional Facilities
- N/A
Continued Training Requirements
- Understanding of PGD legal requirements: Required for all staff
- Treatment/administration competence: Required for all staff
- Drug knowledge (side effects & contraindications): Required for all staff
- On-going competency improvement: Required for all staff
Management & Monitoring of Patient Group Directions (PGD-03)
- Individual Healthcare Professional Authorisation: Required for use of PGD.
Management & Monitoring of Patient Group Direction PGD-03
- Healthcare Professional Authorisation: Required by all healthcare professionals using the PGD.
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Description
This quiz covers the Patient Group Direction (PGD) for the supply of nitrofurantoin to treat uncomplicated urinary tract infections (UTIs) in females aged 16-64. It includes details on the lead commissioner, approval dates, and development process. Test your understanding of PGDs and their application in clinical practice.
