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Not yet recruiting NCT07686055

Precision Management of Urinary Tract Symptoms in Older Women

Phase III Interventional Urinary Tract Infection (Diagnosis)

For patients and families

In plain language

An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.

What is being studied
The protocol lists: Antibiotics.
Who it may be relevant to
Registry conditions: Urinary Tract Infection (Diagnosis). Basic parameters: from 65 years · Female.
What needs checking
Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
Where it takes place
United States
Next step
Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →

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Official title

Precision Management of Urinary Tract Symptoms in Older Women: A Randomized Trial to Reduce Overtreatment

Overview

This project aims to improve the diagnosis and management of urinary tract symptoms in older women by comparing three common treatment strategies-empiric antibiotics, urinalysis-guided therapy, and culture-directed care-in a randomized trial. By integrating patient-reported outcomes, laboratory data, the study will identify which patients benefit from antibiotics and which can safely avoid them. Findings will inform precision care strategies and promote antibiotic stewardship while improving symptom outcomes and quality of life in this high-risk population.

Detailed description

Complete a 3-arm randomized pilot trial of either empiric, urinalysis-directed or culture-directed management for UTI symptoms in older women (≥age 65 years old) with a history of recurrent UTI. We will recruit and enroll 90 women with a history of rUTI from the University of Pittsburgh Medical Center - Women's Center for Bladder and Pelvic Health and the Pitt+Me® Research Registry. Once enrolled and randomized, women will be followed for a total of 28 days.

Interventions

  • Drug Antibiotics
    Participants will be provided either nitrofurantoin 100 mg oral twice a day for 5 days, trimethoprim/sulfamethoxazole 875/125 oral twice a day for 3 days, fosfomycin 3g once oral, ciprofloxacin 250 mg oral twice a day for 5 days or cephalexin 500 mg oral twice a day for 5 days

Primary outcome measures

  • Clinical Success at 14 Days [Time frame: 14 days]
Secondary outcome measures (4)
  • UTI sequelae [Time frame: 30 days]
  • Positive urine cultures [Time frame: 5 days]
  • Change from Baseline in Recurrent Urinary Tract Infection Symptom Scale Score at 14 Days [Time frame: 14 days]
  • Antibiotic appropriateness of Current Therapy [Time frame: 5 days]

Eligibility criteria

Inclusion criteria

  • Female biologic Sex
  • Age ≥65 years old
  • History of recurrent UTI per patient report of greater than 2 UTIs in the last 6 months or 3 UTIs in the last year
  • Patient reported UTI defined as:
  • Dysuria, increased urinary urgency/frequency and/or suprapubic pain

Exclusion criteria

  • Male biologic sex
  • Age <65 years old
  • History of augmentation cystoplasty or cystectomy
  • Currently performing clean intermittent self-catheterization
  • Current indwelling foley catheter
  • Urinary tract instrumentation (i.e., cystourethroscopy, foley catheter placement) in the last 30 days
  • Undergoing treatment for malignancy
  • History of either confirmed or patient reported pyelonephritis and/or urosepsis
  • Cirrhosis and/or end stage liver disease
  • Chronic kidney disease with most recent estimated glomerular filtration rate <50 ml/min
  • Dementia and/or currently reside in skilled nursing facility
  • Current high-dose chronic steroids (>20mg/day of prednisone)
  • Previous solid organ transplant
  • Provider concern for pyelonephritis and/or sepsis (i.e., fevers)
  • Unwilling or unable to comply with study procedures (including ability to complete electronic questionnaires)

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation
Randomized
Model
Parallel assignment
Masking
Open label
Primary purpose
Treatment

Study locations

United States · 1 center
  • UPMC-Magee Womens Hospital — Pittsburgh

Identifiers

NCT: NCT07686055 · STUDY26050198

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗