GPs handle routine UTIs with confidence; children, men, older and recurrent cases are where it unravels

The edition in brief

A qualitative evidence synthesis in the British Journal of General Practice pooled 32 studies of 677 primary care practitioners managing urinary tract infections. Clinicians felt confident with the typical case but uncertain when the patient was a child, a man, an older adult or someone with recurrent infection, and system pressure and patient expectations added to the difficulty of weighing antibiotic benefit and harm. The practical response is to plan those consultations in advance rather than improvise them. An American Family Physician review sets out a structured approach to ear pain: separate primary from referred otalgia, and treat persistent, severe or unilateral pain as a red flag. A BJGP qualitative study of 56 people with dementia, carers and professionals found anxiety and depression are often attributed to dementia itself, with stigma and culture delaying help-seeking. A Family Practice chart review of 155 patients found sleep measures improved after a hybrid of telehealth CBT for insomnia and an online portal, and two-thirds of those tapering hypnotics stopped them; it was uncontrolled. The pearl covers antibiotic duration for UTI in men.