Websites on urinary tract infections

Dr Keith Barnard recommends websites relating to this week's Clinical Review.

FEMALE UTI

This is one of those all-you-need-to know and a bit more articles.

If you are studying for an exam or want to revise your knowledge in depth, this is the place for you. But it is a bit too heavy for a quick brush up.

It runs to 15 pages, so there is definitely a touch of overkill in the GP knowledge department, but if you stick to the history, physical signs and differential diagnosis, it is not that overwhelming.

The drug list looks a little intimidating at first sight but this is one of the more useful sections. All the drugs you are likely to use are listed, together with adult and paediatric doses, contraindications, interactions, and use in pregnancy.

Why go there: bags of information.
Downside: not the place for a quick read.
Information from: eMedicine, University of Chicago.
Address: www.emedicine.com/emerg/topic626.htm

TREATMENT OF UTI

This site may at first seem unimaginative, but in reality makes an excellent reference point for treating UTI in the community.

I would recommend this site to any GP registrar who needs to brush up on the topic. It does not look very appealing, but it carries some key messages.

The site discusses what to do when UTI seems evident but the urine culture is negative - an all too common scenario - and then goes on to look at something that all GPs are constantly faced with - empirical therapy.

Duration of treatment is considered, and the article then moves on to special populations, including pregnant women and the elderly.

There are links that address such issues as prophylactic treatment, patient-initiated therapy, the role of oestrogen replacement therapy, as well as discussing prostatic problems in men.

This is all good, relevant stuff and I highly recommend it.

Why go there: excellent advice on treatment in primary care.
Downside: the presentation could be better.
Information from: British Society for Antimicrobial Chemotherapy
Address: www.bsac.org.uk/pyxis/UTI/UTI/Urinary% 20tract%20infection.htm

A DOUBTFUL DOWNLOAD

I was all set to talk about a herbal remedy site, not perhaps in glowing terms, but at least to praise the fact that it offered a great deal of common-sense advice.

Then I came across this one, and my hackles rose when I read this, boxed and in bold red: '... Doctors won't think twice about treating your urinary tract infection with antibiotics ...' and then railed against all the damage antibiotics could do.

Antibiotics are certainly not the perfect solution, but is that justification to claim that patients can cure themselves within a few hours using a natural home remedy employing 'grocery store ingredients'?

This does not involve herbs, shamans or a colonic washout, but simply sending for a report that is downloaded for about £16. So highly does this company value its secrets, that when you order you will receive another £60 worth of wonder cures absolutely free, including how to treat your kidney stones.

As I looked for who was behind this offer, the words 'grocery store ingredients' rang a bell. I looked back through my notes and saw that I had written about a similar enterprise some six weeks ago, only this time it was GORD that was being cured by a quick trip to the supermarket.

I scoured the page and, yes, it is the same company. I wonder how many more of these 'reports' I will come across?

Why go there: I can't think of a good reason.
Downside: someone is on to a good thing, and it isn't the patient.
Information from: Barton Publishing Inc.
Address: http://utireport.com/

INFORMATION FOR PATIENTS

I was surprised how difficult it was to get a simple advice sheet for women with recurrent UTIs. I eventually opted for this website because it has a broader scope than most.

It deals adequately enough with bacterial cystitis, although a few simple line drawings would have helped emphasise the key points of causes and prevention.

Interestingly, it also covers interstitial cystitis, a less common but distressing condition, and the overactive bladder. And for those who are into that sort of thing, there is a message board and a chat room.

Why go there: may help answer patients' questions.
Downside: it would be better with illustrations.
Information from: The Cystitis and Overactive Bladder Foundation
Address: www.cobfoundation.org/

- Dr Barnard is a former GP in Fareham, Hampshire

WEBSITE OF THE WEEK

When talking of UTIs and cystitis, the interstitial variety is not the first that comes to mind. But if you have a patient with this debilitating disease, you will find these well-illustrated pages helpful.

They explain the symptoms, the relapsing course of the disease and confirmation of the diagnosis. Treatment is difficult and aimed at symptom relief.

Having this additional information is certainly worthwhile for management.

Why go there: comprehensive coverage of a troublesome condition.
Downside: none.
Information from: American Family Physician.
Address: www.aafp.org/afp/20011001/1199.html

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