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GPs should limit courses of antibiotics to three days in most women with urinary tract infections, Cochrane researchers conclude.

Their analysis of 32 trials, published in the latest issue of the American Journal of Medicine, found a three-day course was about as effective as five- to 10-day courses for achieving symptomatic cure. Although longer courses of antibiotics were more effective in achieving bacteriological cure, they were associated with more adverse effects.

In the wake of the review, the National Prescribing Centre criticised GPs for not following guidance to limit trimethoprim prescribing to three days.

The centre's new MeReC extra briefing said there was 'wide variation between practices even in the same primary care trust' and 'room for substantial improvement'.

It added: 'In some practices the proportion of three-day trimethoprim prescriptions is over 60 per cent yet others only supply longer courses.'

The Cochrane reviewers suggested longer courses of antibiotics should be reserved for women in whom eradication of bacteriuria was important ­ for example in those with recurrent infections or in UTI complicated by fever.

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