WESTPORT, CT (Reuters Health) Jul 02 - A management strategy in which women with recurrent urinary tract infections (UTIs) initiate self-treatment based on symptoms is safe and feasible, according to results of a prospective study conducted at the University of Washington in Seattle. In the protocol described in the Annals of Internal Medicine for July 3, women who had experienced at least two UTIs in the previous year were given a 3-day supply of ofloxacin or levofloxacin. Dr. Kalpana Gupta and associates instructed the women to collect urine specimens for culture prior to initiating treatment when they developed new symptoms suggestive of a UTI. During followup, 88 of 172 enrolled women self-diagnosed a mean of two UTI episodes each. Ninety-four percent of episodes were considered definite or probable UTI based on culture results and microscopic evaluation. All episodes responded clinically to self-treatment. The subjects were able to differentiate mild symptoms from those requiring treatment. In fact, 64 women reported 106 episodes of mild dysuria, urgency, burning and frequency for which they did not initiate treatment. In each of these cases, symptoms resolved spontaneously. "Women also felt that they were able to start therapy earlier, had a shorter duration of symptoms, and were able to resume normal activity sooner than with previous episodes of UTI that had been managed traditionally (that is, by consulting a healthcare provider before starting therapy)," Dr. Gupta and her colleagues write. In an editorial, Dr. Andrew Hersheimer, of the United Kingdom Cochrane Centre in Oxford notes that "patients' opinions and feelings are not routinely elicited or listened to....That is a serious loss to medicine." To counter that trend in conventional medical practice, an electronic Database of Individual Patients' Experience (DIPEx) is being developed in the UK, in which patients describe their experiences of disease. Dr. Hersheimer is hopeful that "these data will be useful as providers learn to better engage patients in their own care." To access the DIPEx Web site, go to www.dipex.org. Ann Intern Med 2001;135:9-16,51-52.