Capella 4025 Assessment 4

Capella 4025 Assessment 4

Student Name

Capella University

NURS-FPX4025 Research and Evidence-Based Decision Making

Prof. Name

Date

Presenting Your PICO(T) Process Findings to Your Professional Peers

Urinary tract infections (UTIs) are a common health problem that significantly impacts women. These infections are marked by symptoms such as frequent urination, urgency, painful urination, and discomfort in the pelvic area. UTIs often lead to multiple healthcare visits and negatively affect quality of life. Approximately 41% of women in the U.S. will experience a UTI during their lifetime, and nearly 10% suffer annually (Bono et al., 2025). Therefore, it is crucial to identify evidence-based strategies to reduce recurrence and improve clinical outcomes. This paper examines the use of prophylactic antibiotic therapy to prevent recurrent UTIs in reproductive-aged women.

Diagnosis: Prognosis, Potential Risks, and Associated Complications

Adult women frequently face recurrent UTIs, which can escalate into serious complications if not adequately managed. Repeated infections can lead to kidney damage, sepsis, and increased hospital readmissions. Symptoms include persistent urinary urgency, pain during urination, and in more severe cases, fever and back pain (Bono et al., 2025). Roughly 50% of women will experience another infection within a year of the initial episode, especially those aged 16 to 35. These recurring infections strain both patients and the healthcare system, leading to approximately 10 million annual outpatient appointments and 2 million emergency visits, costing about $1.6 billion each year (Wang & LaSala, 2021).

Comorbidities such as diabetes, chronic kidney disease (CKD), and neurological disorders further increase susceptibility to UTIs. A Kaplan-Meier study indicated that individuals with these conditions and higher frailty scores are significantly more likely to develop UTIs (Chao et al., 2021). Postmenopausal changes, incomplete bladder emptying, and urinary incontinence are additional contributing factors. Prevalence varies by age: 4.5% in ages 16–50, 15% in ages 51–70, and 22% in those over 70. Patients with type 2 diabetes are especially vulnerable, with a projected incidence rate of 6,058 per 10,000 people (Bodke et al., 2023). Psychosocial elements like depression and limited healthcare access also exacerbate the risk. If untreated, UTIs can lead to chronic conditions like pyelonephritis and antibiotic resistance. A case example involves a patient whose minor symptoms progressed to renal damage due to a lack of early intervention. Preventive strategies such as prophylactic antibiotics are essential to mitigate these risks (Alghoraibi et al., 2023).

Formulating the Research Question

To address the clinical problem of recurrent UTIs, the following PICO(T) question was developed: In adult women experiencing recurrent UTIs (P), how does daily prophylactic antibiotic use (I) compared to no prophylaxis or usual care (C) impact the recurrence rate and patient health outcomes (O) over a 12-month period (T)?

This research question adheres to the PICO(T) framework:

PICO(T) Component	Description
Population (P)	Adult females with recurrent urinary tract infections
Intervention (I)	Daily administration of prophylactic antibiotics
Comparison (C)	Standard care or absence of prophylactic antibiotic use
Outcome (O)	Decreased UTI recurrence and enhanced patient outcomes
Time (T)	Twelve-month observation period

The population includes adult women suffering from recurring UTIs, leading to a diminished quality of life. The intervention targets daily use of antibiotics as a preventive measure, shifting away from reactive treatment. The comparison is between no prophylaxis and standard reactive treatment. Desired outcomes involve reduced infection recurrence and improved well-being. A 12-month duration allows a comprehensive evaluation of long-term effectiveness (Luchristt et al., 2024).

Summary of Evidence from Peer-Reviewed Sources

The literature review was conducted using databases such as PubMed, CINAHL, Cochrane Library, and Google Scholar, ensuring the use of credible and up-to-date sources. The CRAAP test was applied to evaluate each source’s reliability (Kalidas, 2021). Four significant studies were selected:

Source	Key Findings
Luchristt et al. (2024)	A 1-month antibiotic plan significantly reduced recurrent UTI rates over 12 months.
Alghoraibi et al. (2023)	Prophylaxis using Nitrofurantoin or Bactrim reduced hospital visits and UTI recurrences.
AUA Guidelines (2025)	Endorses prophylactic antibiotics for women with frequent UTIs.
Liu et al. (2020)	Eight RCTs revealed antibiotics post-catheter removal reduced UTI risk, especially in older adults.

These studies validate the effectiveness of prophylactic antibiotic use in managing recurrent UTIs. They offer robust support for clinical application, particularly among high-risk populations.

Evidence-Based Response to the PICO(T) Question

The reviewed studies support the effectiveness of daily prophylactic antibiotics in reducing UTI recurrence. These infections are known to prolong symptoms and increase healthcare dependency. With interventions like continuous antibiotics, patient outcomes improve, including fewer hospital admissions and better overall well-being (Luchristt et al., 2024; Liu et al., 2020). The assumption is that patients will adhere to the regimen and healthcare teams will monitor side effects and efficacy. Factors like socioeconomic status and access to healthcare must be considered when personalizing treatment strategies. Further research should focus on tailoring prophylaxis plans to individual patient profiles.

Essential Care Steps Guided by Evidence-Based Recommendations

Implementing preventive strategies for recurrent UTIs begins with a thorough clinical evaluation to determine infection frequency and severity. Accurate assessment helps tailor treatment options. For high-risk patients, daily low-dose antibiotics reduce the chance of recurrence and complications (Alghoraibi et al., 2023). The next step includes applying evidence-based prophylaxis regimens such as Nitrofurantoin or Bactrim. These medications are effective in managing symptoms and preventing hospitalizations. Finally, educating patients about hydration, hygiene, symptom monitoring, and adherence to prescriptions is essential. This comprehensive approach enhances engagement and improves clinical outcomes (AUA, 2025).

Conclusion

In summary, evidence strongly supports the use of daily prophylactic antibiotics in adult women with recurrent UTIs. This approach reduces infection recurrence, improves quality of life, and minimizes healthcare system strain. By applying evidence-based practices, clinicians can significantly improve patient outcomes and reduce the frequency of emergency care visits.

References

Alghoraibi, A., Asidan, A., Aljawaied, R., Almukhayzim, N., Alsaydan, H., Alamer, Y., Baharoon, S., Masuadi, E., Shukairi, M., Layqah, L., & Baharoon, R. (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.

Bodke, A. A., Nimbalkar, M. R., Patel, M., & Deshmukh, S. (2023). Impact of type 2 diabetes on urinary tract infections. International Journal of Diabetes in Developing Countries, 43(1), 89–96. https://doi.org/10.1007/s13410-023-01067-2

Capella 4025 Assessment 4

Bono, M. J., Levin, J., & Harper, L. (2025). Epidemiology and impact of urinary tract infections in women: A national survey. Urology Clinics of North America, 52(1), 15–29.

Chao, C. T., Wang, C. Y., Shih, C. J., & Hung, K. Y. (2021). Frailty predicts infection risk in elderly patients with chronic kidney disease. Nephrology Dialysis Transplantation, 36(3), 512–520.

Kalidas, R. (2021). Evaluating health research using the CRAAP method. Journal of Health Literacy Research, 12(4), 240–247.

Liu, B., Zhao, Y., Wang, M., & Zhang, L. (2020). Prophylactic antibiotics for prevention of urinary tract infections after catheter removal: A systematic review and meta-analysis. American Journal of Infection Control, 48(8), 910–916. https://doi.org/10.1016/j.ajic.2020.01.013

Luchristt, B. S., Mahoney, K. J., & Patel, K. R. (2024). Prophylactic antibiotics in recurrent urinary tract infections: A 12-month follow-up. Urology, 175, 78–85. https://doi.org/10.1016/j.urology.2023.10.007

Capella 4025 Assessment 4

Wang, R., & LaSala, P. (2021). Healthcare costs of urinary tract infections in the U.S.: A retrospective analysis. Journal of Managed Care Medicine, 24(3), 33–40.