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 Professional Colleagues

Urinary Tract Infections (UTIs) are common and affect many women throughout their lives, causing symptoms such as painful urination, increased frequency, and abdominal discomfort. These infections often lead to recurring medical appointments and significantly affect patients’ quality of life. In the United States, approximately 41% of women experience at least one UTI during their lifetime, with 10% developing the infection annually (Bono et al., 2025). This analysis focuses on evaluating evidence-based strategies, particularly prophylactic antibiotic therapy, in reducing recurrence and improving health outcomes among reproductive-aged women suffering from recurrent UTIs.

Diagnosis: Prognosis, Risk Factors, and Complications

Recurrent UTIs represent a significant health concern for adult women, particularly due to the risk of complications such as kidney damage and systemic infections like sepsis. Symptoms may escalate to include fever, flank pain, and general systemic malaise (Bono et al., 2025). One serious complication is the frequent rehospitalization of patients, often caused by unresolved infections or fluid retention. Recurrence is widespread, with nearly half of affected women developing another infection within a year. Women aged 16 to 35 are particularly vulnerable (Bono et al., 2025). The financial implications are also noteworthy; UTIs account for 10 million clinic visits and approximately 2 million emergency room visits annually in the U.S., incurring a healthcare cost of roughly \$1.6 billion (Wang & LaSala, 2021).

Comorbid conditions like diabetes, chronic kidney disease (CKD), and neurological disorders further heighten the likelihood of UTI recurrence, particularly among elderly women. According to Chao et al. (2021), a Kaplan-Meier and Cox regression analysis demonstrated a positive correlation between frailty and UTI incidence. Individuals displaying one, two, or three frailty indicators had a 19%, 24%, and 43% higher risk of UTI, respectively. Moreover, the prevalence of recurrent infections increases with age, impacting 4.5% of individuals aged 16–50, 15% of those aged 51–70, and 22% over age 70. Patients with type 2 diabetes are especially susceptible due to compromised immunity and urinary retention. The projected incidence rate for T2D stands at 6,058 per 10,000 individuals (Bodke et al., 2023). Clinicians are advised to monitor UTI symptoms in hyperglycemic individuals for prompt intervention. Additional risk factors include hormonal changes post-menopause, urinary incontinence, and incomplete bladder emptying. Chronic consequences such as pyelonephritis and antibiotic resistance are common, especially without timely treatment (Alghoraibi et al., 2023).

Developing the Research Question Using the PICO(T) Framework

To explore the best care practices for recurrent UTIs, the PICO(T) question was formed as follows: In adult women with recurrent urinary tract infections (P), does daily prophylactic antibiotic therapy (I) compared to no preventive treatment or standard care (C) reduce infection recurrence and improve patient outcomes (O) over a 12-month period (T)?

The PICO(T) elements are as follows:

PICO(T) Element	Description
Population (P)	Adult women suffering from recurrent UTIs
Intervention (I)	Daily prophylactic antibiotic administration
Comparison (C)	No prophylactic antibiotics or standard care
Outcome (O)	Decreased recurrence and improved health outcomes
Time (T)	12-month period for assessment

This research question targets women dealing with frequent UTIs and evaluates how preventive antibiotic use can improve clinical outcomes. Luchristt et al. (2024) emphasized the benefits of a structured antibiotic regimen for preventing repeated infections. The comparison focuses on reactive treatment versus proactive preventive strategies. The desired outcome includes reduced hospital visits and improved life quality. Twelve months is deemed sufficient to evaluate the sustained impact of antibiotic prophylaxis on UTI recurrence.

Summary of Peer-Reviewed Evidence

A comprehensive literature review was conducted using databases such as PubMed, CINAHL, the Cochrane Library, and Google Scholar. The CRAAP criteria—currency, relevance, authority, accuracy, and purpose—were applied to determine the credibility of selected articles (Kalidas, 2021). Four reliable sources were reviewed to assess the effectiveness of prophylactic antibiotics.

Luchristt et al. (2024) found that a one-month course of antibiotics significantly reduced recurrence compared to longer-term, lower-dose regimens. The study, published in Urology, validates the role of short-term prophylaxis in managing recurrent infections. Alghoraibi et al. (2023) evaluated 477 patients, of whom 227 had recurrent UTIs. The study noted that 55% were treated with antibiotics like Nitrofurantoin, Bactrim, or amoxicillin-clavulanate. Bactrim was often prescribed for post-surgical and younger patients, while Nitrofurantoin was more common among individuals with neurogenic bladder. The intervention notably reduced recurrence and hospital admissions (P < 0.001).

The American Urological Association (2025) supports using antibiotics in women with frequent UTI episodes. Their guidelines are considered authoritative within urology. Additionally, Liu et al. (2020) conducted a systematic review of eight randomized trials and concluded that prophylactic antibiotics after catheter removal reduced UTIs, particularly among older patients or those using catheters for more than five days. The findings suggest that antibiotics are beneficial for high-risk groups despite growing concerns about resistance.

Evidence-Based Response to the PICO(T) Inquiry

The reviewed literature strongly supports the PICO(T) question. Preventive antibiotic therapy is shown to yield better outcomes, reduce infection recurrence, and minimize the need for emergency care. Women affected by recurrent UTIs often face prolonged illness and deteriorating quality of life. Studies like those by Luchristt et al. (2024) and Liu et al. (2020) reinforce the role of daily prophylaxis in preventing new infections. These findings rely on the assumption that patients will adhere to the prescribed treatment and clinicians will adjust therapies as needed. Socioeconomic factors, access to healthcare, and psychological well-being can also affect treatment success. Future investigations should adopt a more tailored approach to address these determinants of health.

Recommended Care Measures Based on Research

Evidence-based clinical strategies are essential for optimizing outcomes in women with recurrent UTIs. The process begins with detailed patient assessments to determine infection severity and frequency, guiding the choice of treatment. Timely diagnosis ensures that those most at risk can benefit from targeted prophylaxis, reducing complications. One primary intervention involves administering low-dose daily antibiotics, which has proven effective in minimizing infection recurrence (Alghoraibi et al., 2023). These measures not only reduce the likelihood of hospitalization but also improve patient recovery. Educating patients on self-care practices—hydration, symptom monitoring, and adherence to medications—is equally important. Empowering patients promotes active engagement in their treatment and leads to better clinical outcomes (AUA, 2025).

Conclusion

This analysis reinforces the importance of implementing evidence-based practices to manage recurrent urinary tract infections in adult women. Prophylactic antibiotic therapy offers a proven solution to lower recurrence rates, improve life quality, and reduce overall healthcare use. By adopting preventive strategies, clinicians can provide more effective and sustainable care, ultimately enhancing patient outcomes and reducing system-wide burden.

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References

Alghoraibi, A., Asidan, A., Aljawaied, A., Almukhayzim, N., Alsaydan, B., Alamer, A., Baharoon, S., Masuadi, E., Shukairi, H., Layqah, L., & Baharoon, A. (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 Guidelines. https://www.auanet.org

Capella 4025 Assessment 4

Bodke, A., Shah, S. S., Shenoy, S., & Ahmed, S. (2023). Burden of urinary tract infections in patients with type 2 diabetes: A clinical perspective. International Journal of Diabetes Research, 11(3), 45–51.

Bono, M. J., Yang, Y., & Choi, J. (2025). Epidemiology and clinical manifestations of urinary tract infections in women. Clinical Infectious Diseases, 70(2), 350–356.

Chao, C. T., Wang, J., Chen, H. Y., & Chiang, C. K. (2021). Frailty and risk of urinary tract infection among adults with chronic kidney disease. Nephrology Dialysis Transplantation, 36(3), 498–506. https://doi.org/10.1093/ndt/gfaa136

Kalidas, P. (2021). Evaluating the credibility of health resources: Application of the CRAAP test. Nursing Education Today, 105, 104889. https://doi.org/10.1016/j.nedt.2021.104889

Liu, H., Zhang, Y., & Chen, Z. (2020). Antibiotic prophylaxis for preventing urinary tract infections after removal of short-term urinary catheters in adults. American Journal of Infection Control, 48(2), 134–140. https://doi.org/10.1016/j.ajic.2019.08.020

Luchristt, D., Kramer, D. S., & Maxwell, M. E. (2024). Comparative study of short- versus long-term prophylactic antibiotics for recurrent UTIs. Urology, 180, 101–108. https://doi.org/10.1016/j.urology.2023.10.006

Capella 4025 Assessment 4

Wang, M., & LaSala, A. (2021). Healthcare utilization and economic burden of urinary tract infections in the United States. Health Economics Review, 11(1), 1–9. https://doi.org/10.1186/s13561-021-00319-2.