Factors affecting decisions to use antibiotic-sparing treatment approaches in women with uncomplicated urinary tract infections: a scoping review protocol.

Objective: This scoping review will explore the evidence on factors influencing the decision to use antibiotic-sparing treatments in women with uncomplicated urinary tract infections.

Introduction: Overuse and misuse of antibiotics are the main drivers of antimicrobial resistance. Antibiotic-sparing treatments, such as symptomatic treatment with analgesics and delayed prescriptions, have considerable potential to reduce antibiotic consumption, but the majority of patients still receive antibiotics without delay. The reasons for the poor implementation of these alternative approaches are unknown. A better understanding of the factors influencing treatment decisions is needed.

Inclusion criteria: This review will consider the experiences and attitudes of health care professionals and women in outpatient settings in high-income countries, regarding the use of antibiotic-sparing treatments for the diagnosis or suspected diagnosis of uncomplicated urinary tract infections (ie, healthy women aged 18-64 years who are not pregnant, immunosuppressed, and have no functional or structural urinary tract abnormalities).

Methods: This review will follow the JBI methodology for scoping reviews. MEDLINE (Ovid), Embase, and the Cochrane Library will be searched to identify peer-reviewed articles: original research (quantitative or qualitative studies, experimental, or observational), reviews, case reports, and case series. Gray literature will also be searched for. Sources in any language from 2000 to 2024 will be included. Three reviewers will screen the sources and extract data using a tool developed by the reviewers. The analysis will use counts and descriptive qualitative content analysis. The results will be presented in visual, tabular, and narrative formats.

Review registration: Open Science Framework osf.io/t8y5e/.