General practitioners’ perspectives on treatment decisions and interprofessional care for women with uncomplicated urinary tract infections: An exploratory qualitative study

Background Antibiotic-sparing strategies, such as delayed prescribing or symptomatic therapy, can reduce antibiotic use in uncomplicated urinary tract infections (UTIs), yet their implementation in primary care remains inconsistent. Within this context, non-physician medical staff within general practices and community pharmacies play increasingly important roles in patient counselling and care coordination, potentially shaping treatment expectations and treatment decisions. This study investigated how general practitioners (GPs) make treatment decisions in the management of uncomplicated UTIs in women and examined their views on the roles of non-physician medical staff and community pharmacies in supporting antibiotic-sparing management. Methods We conducted an exploratory qualitative interview study with GPs who regularly manage women with uncomplicated UTIs. Virtual, semi-structured interviews were conducted. Interviews were transcribed verbatim and analyzed thematically. Results Fifteen GPs participated; their mean age was 46.6 years, 53.3% were female, and their experience in general practice ranged from 5 to 25 years. The thematic analysis generated six themes capturing clinical, relational, practical, and interprofessional influences on UTI management. Most GPs reported prior experience with antibiotic-sparing strategies, but thresholds for antibiotic prescribing varied and were shaped by clinical factors, patient expectations, trust, and practical constraints. Practice staff already influenced UTI management, both directly through triage, testing, and counselling and indirectly through practice routines and care pathways, while GPs differed in the degree of professional autonomy they considered appropriate. Pharmacy-based care was often only partly visible to GPs, with experiences varying according to local relationships and professional roles. Discussion The findings suggest that antibiotic-sparing UTI management extends beyond the GP prescribing decision and is shaped across the broader care pathway. Clearer professional roles, appropriate training, and feasible communication structures may support more coordinated care and antimicrobial stewardship in primary care.