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Precision Management of Urinary Tract Symptoms in Older Women
Precision Management of Urinary Tract Symptoms in Older Women: A Randomized Trial to Reduce Overtreatment
Who can join
Ages 65 and older · Women
Full 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)
About the study
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.
What is being tested
- Antibiotics (drug)
Sponsor: Megan Bradley · Participants: 90 · Started: Jul 23, 2026
Contact the study team
- Megan S Bradley, MD MSc · Phone: 412-641-7850
Official record on ClinicalTrials.gov — NCT07686055
Locations in the U.S.
| Pennsylvania | UPMC-Magee Womens Hospital, Pittsburgh |
Conditions
From ClinicalTrials.gov, data retrieved Nov 15, 2026. Each study sets its own eligibility; the study team decides who can join.