EVOLUTION
Research type
Research Study
Full title
EVOLUTION Trial: EValuating a nOveL UTI dIagnOstic for aNtibiotic stewardship
IRAS ID
338088
Contact name
Research Governance Ethics Assurance
Contact email
Sponsor organisation
University of Oxford
Duration of Study in the UK
2 years, 5 months, 31 days
Research summary
Half of all women experience at least one urinary tract infection (UTI) in their lifetime, making it the most common bacterial infection managed in primary care. UTI’s are responsible for over 6 million antibiotic prescriptions annually in the UK. Over-prescribing antibiotics increases the risk of bacteria developing resistance, so antibiotics should only be prescribed when there is a confirmed bacterial UTI diagnosis.
UTI tests used in GP surgeries are often inaccurate and more reliable tests can take up to 3 days in a central laboratory. Consequently, many women are prescribed antibiotics based only on their symptoms.
An exciting new test, called the Sysmex PA-100 AST System manufactured by Sysmex Astrego, could revolutionise UTI treatment in GP surgeries. This test can detect bacteria in urine within 15 minutes, and provide advice on effective antibiotics within another 30 minutes. This will help doctors and nurses to quickly decide whether antibiotics are needed.
The study will recruit 984 women with possible UTI symptoms who contact their GP. Participants will be randomly assigned to receive their usual GP care, or the same care plus the new diagnostic test. We will compare outcomes between the two groups to see if the new test reduces antibiotic use without prolonging symptoms.
We will also record whether women need further healthcare for their UTI symptoms to understand the costs and benefits of using the new test in primary care. To explore how the test could be implemented into NHS care, feedback will be collected from both women and GP practice staff about their experiences with UTI care during the study.
Women with experience of recurrent UTI and members of the charity Bladder Health UK have been actively involved in designing the study and will continue to assist with sharing findings with interested patient and policy groups in the most effective ways.REC name
West Midlands - Solihull Research Ethics Committee
REC reference
25/WM/0233
Date of REC Opinion
19 Nov 2025
REC opinion
Favourable Opinion