Vanessa suffers from recurrent cystitis, a very intense pain that feels like a knife when she urinates and gives her goosebumps. This is usually caused by an infection, which is effectively and relatively easily treated with antibiotics. However, due to the need for a prescription, she often has to wait days for an appointment at her health center, which she cannot afford to do to avoid suffering and complications. As a result, she ends up in the emergency room, waiting for hours when all she needs is a simple urine test.
A new regulation approved by the Ministry of Health this week allowing nurses to prescribe antibiotics for urinary tract infections without the need for a doctor’s intervention is considered “very good news” by Vanessa, a 53-year-old woman who often suffers from cystitis. She believes this regulation will make access to healthcare more accessible, as nurses are more readily available at her health center and are usually the ones who conduct tests and make diagnoses. This move emphasizes a philosophy that has been in place for almost 10 years, increasing nurses’ competencies and aligning with practices in other countries like the UK.
Urinary tract infections account for about 5% of women’s medical consultations, with more than half of women experiencing at least one in their lifetime. In most cases, the cause is a microorganism, Escherichia coli, which responds well to antibiotics that nurses can now prescribe: Fosfomycin tromethamine (Monurol) and Nitrofurantoin. Some women are more prone to these infections due to hormonal changes, hygiene habits, or sexual behavior, while for others, the cause remains unclear. For Vanessa, even something as simple as wearing a wet swimsuit can trigger a cystitis episode.
While cystitis is more common as individuals age, it can also occur at younger ages. Mara, a 35-year-old woman, has been struggling with cystitis since adolescence, experiencing constant urge to urinate, intense pain, and even kidney complications. The new guidelines approved by the ministry aim to serve as a reference framework for nurses to treat women over 14 years old with uncomplicated infections, excluding complex cases that require medical evaluation, such as recurrent infections or underlying medical conditions.
The nursing profession, which has been advocating for expanded competencies and recognition for years, welcomes this development as a step toward optimizing healthcare resources and reducing patient wait times. However, the Spanish Society of Primary Care Physicians (Semergen) opposes the new guidelines, stating that prescribing medication is a highly responsible act that requires medical training and expertise. They argue that antibiotic selection and treatment should be a result of a comprehensive diagnostic process led by a physician.
Despite the opposition from Semergen, the Federation of Family and Community Nursing Associations (FAECAP) defends the new regulations, emphasizing that nurses focus on health promotion, community care, and are well-equipped to manage common clinical situations like cystitis. Rather than aiming to ease consultation burdens, FAECAP believes this change should recognize nurses’ true competencies and advocate for a broader shift in medication regulations. Implementation of these guidelines still varies across regions, with some communities yet to enable nurses to access electronic prescribing systems for cystitis and other conditions.
