{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T03:11:51Z","timestamp":1785553911613,"version":"3.56.0"},"reference-count":26,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"GSK","award":["(study 212519)"],"award-info":[{"award-number":["(study 212519)"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Uncomplicated urinary tract infections (uUTIs) represent a sizable healthcare burden with a substantial negative impact on patients\u2019 health-related quality-of-life (HRQoL). However, the HRQoL impact of uUTI from the patient perspective is under-represented in research. A cross-sectional online survey assessed activity impairment and work productivity, HRQoL, costs, and treatment satisfaction of female patients with uUTIs in the US; the current study applies this earlier methodology to Germany to provide a European perspective. We examined: activity impairment and work productivity using Activity Impairment Assessment (AIA), and Work Productivity and Activity Impairment (WPAI) questionnaires, respectively; HRQoL using a modified Short Form-36, and participants completed the treatment satisfaction questionnaire for medication. Participants (\u2265 12 years) self-reported a uUTI treated with oral antibiotics in the last 60 days, had no evidence of complicated UTI, and were recruited via a consumer panel. In the patient (N = 200) survey, bladder pain (70%), dysuria (69%), and frequent urination (66%) were the most common uUTI symptoms reported. Activities frequently affected by uUTI were sexual activity (56%) and exercise (48%), resulting in an overall AIA score of 8.2 indicating that activities among patients were impaired \u2018most of the time\u2019 during their recent uUTI. Absenteeism was 29% (of a 40-hour work week); presenteeism, 34%; and overall work impairment, 41%. Indirect costs due to impact of uUTI were \u20ac7.62\/hour\/participant, representing a loss for the employer. The lowest HRQoL scores were for mental (44%) and physical components (43%); emotional and physical functioning scores were 71% and 70%, respectively. Mean direct costs of \u20ac20.10 for medical treatments and \u20ac11.30 for other treatment costs were reported. Overall, most participants were satisfied with the uUTI treatment (76% satisfaction score). Results demonstrate the patient-reported burden of uUTI for patients and employers, with activities and ability to work impacted, resulting in a notable indirect burden in Europe.<\/jats:p>","DOI":"10.1371\/journal.pone.0313752","type":"journal-article","created":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T18:30:36Z","timestamp":1736274636000},"page":"e0313752","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Activity impairment, work productivity, health-related quality-of-life, and costs associated with uncomplicated urinary tract infection among females in Germany"],"prefix":"10.1371","volume":"20","author":[{"given":"Megan","family":"O\u2019Brien","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alen","family":"Marijam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanny S.","family":"Mitrani-Gold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Terry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavin","family":"Taylor-Stokes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7089-1545","authenticated-orcid":true,"given":"Ashish V.","family":"Joshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,1,7]]},"reference":[{"issue":"5","key":"pone.0313752.ref001","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1038\/nrmicro3432","article-title":"Urinary tract infections: epidemiology, mechanisms of infection and treatment options","volume":"13","author":"AL Flores-Mireles","year":"2015","journal-title":"Nat Rev Microbiol"},{"issue":"2","key":"pone.0313752.ref002","doi-asserted-by":"crossref","first-page":"bjgpopen18X101630","DOI":"10.3399\/bjgpopen18X101630","article-title":"Challenges in managing urinary tract infection and the potential of a point-of-care test guided care in primary care: an international qualitative study.","volume":"3","author":"L Brookes-Howell","year":"2019","journal-title":"BJGP Open."},{"issue":"4","key":"pone.0313752.ref003","doi-asserted-by":"crossref","first-page":"e0000320","DOI":"10.1128\/CMR.00003-20","article-title":"The five Ds of outpatient antibiotic stewardship for urinary tract infections","volume":"34","author":"MC Goebel","year":"2021","journal-title":"Clin Microbiol Rev"},{"issue":"1","key":"pone.0313752.ref004","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1080\/02813432.2019.1569425","article-title":"Prescription of antibiotics for urinary tract infection in general practice in Denmark.","volume":"37","author":"A Holm","year":"2019","journal-title":"Scand J Prim Health Care"},{"issue":"11","key":"pone.0313752.ref005","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1002\/psb.1362","article-title":"Urinary tract infections: diagnosis and management.","volume":"26","author":"CO Durojaiye","year":"2015","journal-title":"J Prescriber"},{"key":"pone.0313752.ref006","doi-asserted-by":"crossref","first-page":"1756287219832172","DOI":"10.1177\/1756287219832172","article-title":"An introduction to the epidemiology and burden of urinary tract infections.","volume":"11","author":"M Medina","year":"2019","journal-title":"Ther Adv Urol"},{"issue":"11","key":"pone.0313752.ref007","doi-asserted-by":"crossref","first-page":"2669","DOI":"10.1007\/s00345-019-03071-4","article-title":"Epidemiology of urological infections: a global burden","volume":"38","author":"R Ozturk","year":"2020","journal-title":"World J Urol"},{"issue":"4","key":"pone.0313752.ref008","doi-asserted-by":"crossref","first-page":"623","DOI":"10.3390\/pathogens12040623","article-title":"Urinary tract infections: the current scenario and future prospects.","volume":"12","author":"G Mancuso","year":"2023","journal-title":"Pathogens"},{"issue":"2","key":"pone.0313752.ref009","doi-asserted-by":"crossref","first-page":"e0277728","DOI":"10.1371\/journal.pone.0277728","article-title":"Activity impairment, health-related quality of life, productivity, and self-reported resource use and associated costs of uncomplicated urinary tract infection among women in the United States.","volume":"18","author":"J Thompson","year":"2023","journal-title":"PLoS One"},{"key":"pone.0313752.ref010","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/1477-7525-3-42","article-title":"Validation of a patient-administered questionnaire to measure the activity impairment experienced by women with uncomplicated urinary tract infection: the Activity Impairment Assessment (AIA).","volume":"3","author":"DJ Wild","year":"2005","journal-title":"Health Qual Life Outcomes"},{"issue":"5","key":"pone.0313752.ref011","doi-asserted-by":"crossref","first-page":"353","DOI":"10.2165\/00019053-199304050-00006","article-title":"The validity and reproducibility of a work productivity and activity impairment instrument.","volume":"4","author":"MC Reilly","year":"1993","journal-title":"Pharmacoeconomics."},{"key":"pone.0313752.ref012","unstructured":"Federal Statistics Office of Germany. Earnings and earnings difference. https:\/\/www.destatis.de\/EN\/Themes\/Labour\/Earnings\/Earnings-Earnings-Differences\/Tables\/quaterly-earnings.html. Accessed 2nd September."},{"key":"pone.0313752.ref013","doi-asserted-by":"crossref","first-page":"2050312116671725","DOI":"10.1177\/2050312116671725","article-title":"SF-36 total score as a single measure of health-related quality of life: scoping review.","volume":"4","author":"L Lins","year":"2016","journal-title":"SAGE Open Med"},{"key":"pone.0313752.ref014","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1186\/1477-7525-7-36","article-title":"Validation of an abbreviated Treatment Satisfaction Questionnaire for Medication (TSQM-9) among patients on antihypertensive medications.","volume":"7","author":"M Bharmal","year":"2009","journal-title":"Health Qual Life Outcomes"},{"issue":"5","key":"pone.0313752.ref015","doi-asserted-by":"crossref","first-page":"316","DOI":"10.5489\/cuaj.687","article-title":"Guidelines for the diagnosis and management of recurrent urinary tract infection in women.","volume":"5","author":"S Dason","year":"2011","journal-title":"Can Urol Assoc J"},{"key":"pone.0313752.ref016","year":"2024","journal-title":"Population of Germany as of December 31, 2022, by age group"},{"issue":"12","key":"pone.0313752.ref017","article-title":"Qualitative Analysis of a Twitter-Disseminated Survey Reveals New Patient Perspectives on the Impact of Urinary Tract Infection.","volume":"11","author":"M Valentine-King","year":"2022","journal-title":"Antibiotics (Basel)."},{"issue":"1","key":"pone.0313752.ref018","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1186\/s12905-022-01757-3","article-title":"The emotional impact of urinary tract infections in women: a qualitative analysis.","volume":"22","author":"L Grigoryan","year":"2022","journal-title":"BMC Womens Health"},{"key":"pone.0313752.ref019","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1186\/1471-2296-15-162","article-title":"How women manage recurrent urinary tract infections: an analysis of postings on a popular web forum.","volume":"15","author":"A Flower","year":"2014","journal-title":"BMC Fam Pract"},{"issue":"639","key":"pone.0313752.ref020","doi-asserted-by":"crossref","first-page":"e702","DOI":"10.3399\/bjgp15X686965","article-title":"Incidence, severity, help seeking, and management of uncomplicated urinary tract infection: a population-based survey.","volume":"65","author":"CC Butler","year":"2015","journal-title":"Br J Gen Pract"},{"issue":"1","key":"pone.0313752.ref021","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1080\/14737167.2017.1359543","article-title":"Social and economic burden of recurrent urinary tract infections and quality of life: a patient web-based study (GESPRIT).","volume":"18","author":"F Wagenlehner","year":"2018","journal-title":"Expert Rev Pharmacoecon Outcomes Res"},{"issue":"2","key":"pone.0313752.ref022","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1080\/23744235.2020.1834138","article-title":"Uncomplicated urinary tract infection in primary health care: presentation and clinical outcome.","volume":"53","author":"H Kornfalt Isberg","year":"2021","journal-title":"Infect Dis (Lond)."},{"issue":"5","key":"pone.0313752.ref023","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1177\/1715163517723036","article-title":"The assessment and management of urinary tract infections in adults: Guidelines for pharmacists.","volume":"150","author":"NP Beahm","year":"2017","journal-title":"Can Pharm J"},{"key":"pone.0313752.ref024","unstructured":"Sabih A. Complicated UTI https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK436013\/. Accessed 31st May."},{"issue":"7","key":"pone.0313752.ref025","article-title":"Severity and Bothersomeness of Urinary Tract Infection Symptoms in Women before and after Menopause.","volume":"12","author":"S Teglbraender-Bjergkvist","year":"2023","journal-title":"Antibiotics (Basel)."},{"issue":"3","key":"pone.0313752.ref026","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1159\/000487645","article-title":"The 2017 update of the German clinical guideline on epidemiology, diagnostics, therapy, prevention, and management of uncomplicated urinary tract infections in adult patients. Part II: therapy and prevention","volume":"100","author":"J Kranz","year":"2018","journal-title":"Urol Int."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0313752","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T18:30:48Z","timestamp":1736274648000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0313752"}},"subtitle":[],"editor":[{"given":"Che Matthew","family":"Harris","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,1,7]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,7]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0313752","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,7]]}}}