Upon meeting with the patient, Mrs. Sarah Jones and listening to her enquiry, I was able to formulate a PICO styled question, for a clearer and more comprehensive framework to assist in the process of evidence-based research1. The key words that I have used as the foundations of my search strategy as shown in Figure 1 include, pregnant, probiotics and UTI. Variations of these key words were also included in this search.
Our Essential Evidence-based Medicine textbook1 suggests using Google and other search engines as a starting point in order to help establish a search strategy to use in other online databases. I used the same key words of the PICO question as a starting point.
Firstly, I searched ‘probiotics uti’ to get general idea of the kind of information I would be faced with. There were 415, 000 results in total. The results were sorted in order of relevance and therefore I made the decision to only look through the first page, which only had 10 results. Of these 10 results, only 2 links were specific to women, and none were exclusive to pregnant women. I made a decision to make my results more specific on pregnancy and women because Mrs. Jones had made an effort to inform me of her pregnancy. I started a new search on Google, typing ‘probiotics uti pregnant’, but again out of the 10 results on the first page, only 2 were relevant to the prevention of UTI with the use of probiotics. Other results explored different aspects like whether probiotics and other methods of treatment were suitable for pregnant women, or were not classed as proper evidence as they were links to forums or magazine articles. Using the word ‘pregnancy’ instead of ‘pregnant’ obtained similar results, also showing the same two articles d...
... middle of paper ...
...le. It is a systematic review from the Cochrane Library published in 2015, making it valid. It is relevant as it focuses specifically on pregnant women. This review would be considered to have a lower potential for bias, because they have only used randomised control trials as the basis of their studies.
I would recommend that this patient in particular could try probiotic supplementation to assist in preventing future outbreaks of urinary tract infection. All of the articles above can be shown as evidence (especially article 5 and 6 which are both specific to pregnant women) to support that probiotics, specifically the Lactobacilli strain has been shown to prevent recurring UTI in women7. Some articles also explore the safety of using probiotic supplementation, and therefore that would not be an issue to worry about since the patient is pregnant3,7,8.
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