UTI red flags — GPhC CRA MCQ

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HardInfectionsUTI red flagsGPhC CRA

A 67-year-old man has two days of dysuria and frequency but no fever, loin pain, retention or confusion. He asks to be treated through the NHS Pharmacy First uncomplicated-UTI pathway. What should the pharmacist do?

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Correct answer: B — Refer the male patient outside the Pharmacy First UTI pathway

Refer the male patient outside the Pharmacy First UTI pathway: The England Pharmacy First uncomplicated-UTI pathway has a defined eligible population; male urinary symptoms need assessment for alternative causes and complications. Treat through Pharmacy First because fever and loin pain are absent: Lack of systemic symptoms does not place a male patient within the pathway population. Use the three-day regimen authorised for eligible non-pregnant women: The regimen and service route cannot simply be transferred to an ineligible patient. Recommend cranberry products and review symptoms after one month: Male urinary symptoms need timely assessment rather than prolonged self-treatment. Arrange emergency assessment for every uncomplicated male urinary presentation: Urgent emergency escalation depends on red flags; timely prescriber assessment is the proportionate action here.

Reference: NHS England Pharmacy First service specification and clinical pathways: https://www.england.nhs.uk/publication/community-pharmacy-advanced-service-specification-nhs-pharmacy-first-service/; NICE NG109: lower UTI antimicrobial prescribing: https://www.nice.org.uk/guidance/ng109/chapter/Recommendations