Personalised Recommendations for preventing recurrent Urinary tract infections and estimation of pharmacological option effectiveness (PREDICT-rUTI)

Recurrent urinary tract infections (rUTIs) affect millions of women globally and are one of the most common reasons for repeated antibiotic use. These infections significantly impact women’s well-being and quality-of-life. They also drive repeated healthcare visits, urine sampling, and antibiotic prescribing, contributing to health service expenditure and antibiotic resistance. Despite the major personal and societal impacts, most rUTIs are treated reactively, with limited clinical evidence to support proactive, personalised prevention of repeated infections. This research aims to inform personalised prevention of rUTIs using real-world data. Inspired by four women with lived experience, it will address four questions: 1. How effective are current pharmacological options for preventing rUTIs? 2. Which women are likely to develop rUTIs? 3. Which women with rUTIs are at highest risk of further infections? 4. Which women will benefit from which specific pharmacological option for preventing rUTIs? To answer these, I will address four objectives: 1. Evaluate the effectiveness of three preventive options: vaginal oestrogen, methenamine hippurate, and antibiotics. 2. Develop three prediction models estimating: the risk of rUTIs, risk of recurrence, and individual response to prevention. 3. Externally validate these models. 4. Explore implementation through stakeholder engagement and user-testing. Keywords: recurrent UTIs, prediction tools, primary care