Women in any state or territory can now visit their pharmacist for UTI treatment.
The Northern Territory has joined the pack on pharmacist-led prescribing for UTI symptoms – bringing the practice nationwide – and it has more scope expansions in the pipeline.
As of Monday, pharmacists in the top end’s 41 chemists can prescribe nitrofurantoin and cefalexin to women with symptoms of uncomplicated cystitis.
Women who are pregnant, under 18, over 65 or who have had antibiotics for a UTI in the previous six months will be excluded.
So will women with chronic kidney disease, anatomically male urinary tracts, kidney stones, paralysis, a history of antibiotic use within the previous fortnight or more than two UTIs in the preceding 12 months.
Nitrofurantoin 100mg will be the first-line treatment, with cefalexin to be prescribed for women with risk factors for chronic kidney disease.
The start of the Northern Territory program means that pharmacists can now prescribe for UTIs in every Australian state and territory.
It was an unwelcome milestone for the RACGP.
“The expansion of UTI pharmacy prescribing across the country is a reckless and regrettable overreach,” college president Dr Nicole Higgins told The Medical Republic.
“Patient safety must come first, and there is no such thing as an ‘uncomplicated’ UTI.”
She also cited the 2022 AMA Queensland survey which suggested that at least 240 patients suffered complications after being treated by pharmacists under the original UTI trial.
AMA president Dr Danielle McMullen, meanwhile, pointed out that there have been very few evaluations of pharmacist-led UTI prescribing.
The only state which has released an evaluation so far was Queensland, and questions were raised about its rigour.
“I think the public should be questioning whether they’re being used as guinea pigs in a trial that’s not a trial,” Dr McMullen said.
“They were sold the idea that this would be a robust clinical framework and that there were trials around the country to establish the effectiveness of this kind of an intervention.
“And yet, it’s been rolled out before all of that in a short-sighted decision from health ministers who are trying to plug a workforce gap.
“It’ll be the public who pays for it in the long run.”
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Under more planned reforms from the Country Liberal Party, pharmacist scope of practice will continue to expand.
A further 22 conditions will be added, including chronic disease management for asthma, treatment of reflux and weight management.
Pharmacy Guild NT branch president Peter Hatswell said the initiative would be “critical to improving healthcare access and efficiency for Territorians”.
