UTI PGD (PDF) - North East North Cumbria

Patient Group Direction (PGD) for the Supply of Nitrofurantoin for uncomplicated Urinary Tract Infections in females aged 16 years and over but under 65 years by community pharmacists accessing UTI PGD NHS Service in North East North Cumbria with Newcastle Gat...

Patient Group Direction (PGD) for the Supply of Nitrofurantoin for uncomplicated Urinary Tract Infections in females aged 16 years and over but under 65 years by community pharmacists accessing UTI PGD NHS Service in North East North Cumbria with Newcastle Gateshead CCG acting as lead commissioner for NENC YOU MUST BE AUTHORISED BY Direction Number: - PGD-03 NAME, UNDER THE CURRENT Valid from: 01 03 2022 VERSION OF THIS PGD BEFORE YOU Review date: 01 09 2023 ATTEMPT TO WORK ACCORDING TO Expiry date: 31 03 2024 IT. This patient group direction has been developed & produced by: - Title Name Signature Date Head of Services & Support for North of Tyne Local Ann Gunning MRPharmS 31/03/2022 Pharmaceutical Committee Regional Antimicrobial Prof Philip Howard OBE Stewardship Lead 31/03/2022 North-East & Yorkshire Region Medical Director NHS Dr Dominic Slowie 31/03/2022 Newcastle Gateshead CCG This PGD has been approved for use across NENC ICB: Title Name Signature Date Organisation North East and North Cumbria Medical Director Dr Janet Walker 12/06/2023 Integrated Care Board Director of North East Medicines and and North Ewan Maule 12/06/2023 Cumbria Pharmacy Integrated Care Board Page 1 of 11 Official 1. Clinical Condition or Situation to Which the Direction Applies Indication (defines situation or condition) Treatment of uncomplicated lower urinary tract infection in females aged 16 years and over but under 65 years of age Objectives of care To allow treatment of included women by community pharmacists without the need for a prescription or the need to attend another service to obtain a prescription Inclusion criteria Healthy, non-pregnant women aged 16-64 years, presenting with: Two or more of the 5 key diagnostic signs or other severe urinary symptoms below: dysuria (burning pain when passing urine) nocturia (passing urine more often than usual at night) Urgency Frequency Visible haematuria And a positive dipstick test for nitrites Note: Use dipstick tests for women presenting for treatment in line with updated SIGN guideline sign-160-qrg-uti_web-version.pdf Exclusion criteria (Refer to current SPC) Only one of the key diagnostic symptoms Two or more of the key diagnostic symptoms AND a negative dipstick test for nitrites Male Under 16 years of age Patients aged 65 years and over Immunocompromised complex multiple morbidities Patients currently taking oral antibiotics Consider pyelonephritis and refer immediately if suspected: - Kidney pain/ tenderness in back under the ribs - New / different myalgia, flu like illness - Shaking, chills (rigors), temperature 37.9˚C or above - Nausea and vomiting Elderly patients with confusion suggestive of UTI Known hypersensitivity to nitrofurantoin Exclude vaginal and urethral causes of urinary symptoms: 2  - Vaginal discharge - Urethritis - Exclude STIs - Genitourinary syndrome of menopause Acute porphyria UTI treated with antibiotics within previous 4 weeks More than two episodes of UTI treated under this PGD within previous 12 months Catheterised patients Haematuria only Blood dyscrasias (G6PD deficiency specifically) Pregnancy and breast feeding Moderate to severe renal impairment (eGFR