Pharmacists could soon be given the power to prescribe UTI medication in South Australia

Like many people, Laura Sarnari knows the pain, discomfort and inconvenience of having a urinary tract infection.

She also knows how hard it can be waiting to see a GP for treatment.

“I’ve unfortunately had to suffer through a painful day and night before I’ve been able to see my GP and that’s been really difficult. It’s meant days off work,” she said.

Ms Sarnari is also a pharmacist, and said she regularly sees other women also struggling to get timely treatment for the condition.

“Unfortunately with great frequency because of that difficulty to get into their GP, we do find that people come into the pharmacy looking for solutions,” she said.

Ms Sarnari is one of many pharmacists hoping for a change in prescribing rules that would allow them to dispense medication to people with UTIs without the need to see a doctor.

Parliamentary inquiry recommends change

For the last nine months, a South Australian parliamentary committee has been investigating UTIs and their treatment.

It was sparked by Labor MP Jayne Stinson, who has experienced the condition, and the frustration of trying to see a GP herself. 

“Fifty per cent of Australian women will face the excruciating pain of a UTI and we owe it to them to find solutions that are going to work for them and relieve their pain,” she said.

The committee found almost 9,000 people end up in hospital with complications from UTIs in South Australia each year, and timely treatment can prevent that.

It is now recommended pharmacists be allowed to prescribe antibiotics for the condition, after a consultation with the patient.

The committee also recommended additional training and reporting requirements be rolled out.

As part of its inquiry, the bi-partisan committee travelled to Queensland to see how a trial of similar rules was handled there.

“But at the same time we’ve implemented things like a two year review and also keeping data so that we can carefully monitor how this rolls out.”

Doctors warning on patient safety

While pharmacists are supportive of the recommendations, doctors are warning against it.

The Royal College of Australian General Practitioners gave evidence to the inquiry, particularly around concerns for patient safety and the danger of the over prescription of antibiotics.

South Australian college chair Sian Goodson said GPs go through a decade of training, and should be involved in the diagnosis of a UTI.

“We know that urinary tract symptoms aren’t always due to a urinary tract infection and don’t always need treatment with antibiotics and can actually be other conditions that need to be diagnosed by a doctor,” Dr Goodson said.

“We also know from studies pharmacists are more likely to prescribe antibiotics for these symptoms than doctors and we have a huge problem with antibiotic resistance globally.”

Dr Goodson said rather than using pharmacies to deal with health system pressures, governments should invest in the primary health care system.

She said patients experiencing UTI symptoms, should be able to access a GP.

“You may not see an appointment available online but if you phone up and explain your symptoms or ask to speak to the practising nurse, most GPs will accommodate that and get people in,” she said.

Government likely to adopt recommendations

Despite the reservations from doctors, the state government looks likely to accept the committee’s recommendations.

Health Minister Chris Picton said now he had the report, he would consider the next steps, but it’s likely he could roll out the changes without first conducting a trial.

“This has been operating now in a number of states, there’s been a number of trials already,” he said.

“I think that we can see this is an issue where there has been trials, there has been work across the states and we now can be in a position where we can implement here in South Australia some changes that can improve people’s access to care.”

Possibility of other medications also available from pharmacies

Along with antibiotics for UTI treatment, the committee recommended pharmacies be given the power to renew prescriptions for contraceptives.

And it said the government should consider a separate Queensland trial of pharmacy prescriptions for 25 other medications.

That includes treatments for skin conditions, ear infections and medication for diabetes and asthma where a treatment plan is already in place.

“These are common medications that pharmacists feel that they are able to prescribe safely but it is controversial so we’d like the minister to have a look at what happens in Queensland and see if it’s appropriate in South Australia,” Ms Stinson said.