Open label feasibility study evaluating D-mannose combined with home-based monitoring of suspected urinary tract infections in patients with multiple sclerosis

Background: It has been identified that nearly one-in-five people with multiple sclerosis (MS) have been admitted to hospital as a non-elective admission in 2018–2019. The average national stay is 7.7 days, at an average cost of £2844. Emergency hospital admissions for people with multiple sclerosis are rising nationally. Method: The authors conducted a 12-month audit of non-elective admissions across two clinical sites, comparing and contrasting the data gathered with national Hospital Episode Statistics. The outcome of the data collection influenced changes in local service delivery. Findings: The most common reasons identified for non-elective admissions related to MS were associated with respiratory issues (4255 admissions), with the most common single cause being urinary tract infections (2960 admissions). Bladder and bowel issues combined also accounted for 3550 admissions in 2018/19. Conclusion: The data identified urinary tract infections and sepsis as the largest presentation of non-elective MS admissions to both trusts. Certain recommendations have been made that will contribute to the improvement of service delivery and better quality care.

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Urinary tract infections and multiple sclerosis: Recommendations from the French Multiple Sclerosis Society

Revue Neurologique ◽

10.1016/j.neurol.2020.02.011 ◽

2020 ◽

Vol 176 (10) ◽

pp. 804-822

Author(s):

C. Donzé ◽

C. Papeix ◽

C. Lebrun-Frenay ◽

C. Donzé ◽

C. Papeix ◽

...

Keyword(s):

Multiple Sclerosis ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Tract Infections

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Does cranberry extract reduce antibiotic use for symptoms of acute uncomplicated urinary tract infections (CUTI)? Protocol for a feasibility study

Trials ◽

10.1186/s13063-019-3860-z ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Oghenekome Gbinigie ◽

Julie Allen ◽

Anne-Marie Boylan ◽

Alastair Hay ◽

Carl Heneghan ◽

...

Keyword(s):

Primary Care ◽

Urinary Tract ◽

Feasibility Study ◽

Urinary Tract Infections ◽

Treatment Options ◽

Sample Size Calculation ◽

Antibiotic Use ◽

Primary Objective ◽

Feasibility Trial ◽

Tract Infections

Abstract Background Consultations in primary care for symptoms of urinary tract infections (UTIs) are common and patients are frequently treated with antibiotics. Given increasing antimicrobial resistance, there has been interest in non-antibiotic treatment options for common infections. One such option is the use of cranberry extract to treat symptoms attributable to UTIs. Methods A target of 45 women consulting in primary care, with symptoms suggestive of an uncomplicated UTI for whom the practitioner would normally prescribe antibiotics, will be randomised to receive one of three treatment approaches: (1) immediate prescription for antibiotics; (2) immediate prescription for antibiotics plus a 7-day course of cranberry capsules and (3) cranberry capsules plus a delayed prescription for antibiotics to be used in case their symptoms do not get better, or get worse. Follow-up will be by daily rating of symptoms and recording of treatments used for 2 weeks in an online symptom diary. Interviews will be conducted with around 10–15 study participants, as well as with around 10–15 women who have experienced a UTI but have not been approached to take part in the study. Both groups will be asked about their experience of having a UTI, their thoughts on non-antibiotic treatments for UTIs and their thoughts on, or experience of, the feasibility trial. The primary objective is to assess the feasibility of undertaking a full trial in primary care of the effectiveness of cranberry extract to reduce antibiotic use for symptoms of acute uncomplicated UTI. The secondary objective is to conduct a preliminary assessment of the extent to which cranberry might reduce antibiotic use and symptom burden. Discussion This feasibility study with embedded interviews will inform the planning and sample size calculation of an adequately powered trial to definitively determine whether cranberry helps to alleviate the symptoms of acute uncomplicated UTIs in women and whether it can safely reduce antibiotic use. Trial registration ISRCTN registry, ID: 10399299. Registered on 24 January 2019.

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