EXECUTIVE SUMMARY
The Select Committee on Access to Urinary Tract Infection Treatment was established on 1
December 2022 pursuant to a resolution to inquire into and report on access to urinary tract
infection treatment in South Australia. The committee was formed to investigate barriers to
access to treatment and assess the applicability of implementing a service similar to
Queensland’s Urinary Tract Infection Community Pharmacy Service in South Australia.
Following advertising on social media, and in The Advertiser and regional newspapers, the
committee received 151 submissions. The committee heard from 24 witnesses and travelled
to Brisbane to see the Queensland service in action and speak to pharmacists, health
administrators and users of the service.
Queensland was the first Australian state to allow pharmacists to treat uncomplicated UTIs,
enabling sufferers to access antibiotics when they might not have been easily able to see a
doctor, or for women who may have experienced symptom onset during the weekend or
evening. Since the Queensland pilot, other states have followed suit and UTI pharmacy
services have begun in New South Wales, the ACT, Victoria, and Western Australia. As
recently as 14 September 2023, Tasmania announced that they were planning to allow
pharmacists to supply UTI medication.
Based on the evidence provided to the committee, the recommendations provided support
implementation of a similar UTI pharmacy service in South Australia. The committee has taken
into consideration the work done in other jurisdictions that have, or are, trialling and
implementing such programs and have produced recommendations that build on these
learnings, to improve access to affordable and accessible healthcare for South Australian
women.
Overwhelmingly, submissions received (~80%) were broadly in favour of a similar UTI
community pharmacy treatment program being introduced in South Australia. The committee
acknowledges the concern that some doctors’ groups have raised regarding such a model
and has carefully considered the evidence provided by these groups. The committee’s
recommendations put forward a South Australian program that is robust, well managed, well
supervised and evidence based. It is the committee’s considered view that allowing
pharmacists to treat uncomplicated UTIs in some situations should be viewed as
complementary to rather than a substitute for, the care provided by a trusted general
practitioner and/or women’s health specialist.
Primarily, the recommendations contained in this report seek to put patients first and reduce
barriers to treatment for urinary tract infections. 
INTRODUCTION BY THE CHAIR
Half of all South Australian women will suffer a urinary tract infection at some point in their
lives. It will usually strike when they least expect it and when it is most inconvenient.
As a sufferer myself, I am all too familiar with the common symptoms of pain, discomfort,
scalding urination and constantly feeling like a dash to the bathroom – even though it may be
unnecessary. The symptoms are often sudden and play havoc with many women’s busy lives,
interrupting their ability to work, play, or care for loved ones.
Effective treatment of a UTI relies on timely access to antibiotics, to ensure complications such
as kidney infections and hospitalisation are avoided. In South Australia, antibiotics are
prescribed by a GP. Being able to get that prescription has become more complicated in recent
times due to a shortage of GPs, and fees are on the rise too, as more doctors stop bulk billing.
With reports of increasing wait times to see a GP, getting access to timely treatment is proving
a challenge for sufferers.
In 2020, Queensland was the first state in Australia to allow pharmacists to treat
uncomplicated UTIs. A pilot enabled pharmacists who undertook specific training to supply
antibiotics to women aged 18-65 who presented with UTI symptoms and met criteria based
on empiric treatment guidelines. In July 2022, this service was made permanent in
Queensland. In the fourteen months since this time, New South Wales, the ACT, Victoria,
Western Australia and Tasmania have followed, either via trial or implementation.
The committee’s aim was to investigate the barriers to access to treatment South Australian
UTI sufferers face, and whether a similar pharmacy service would be appropriate in this state.
The committee received 151 submissions, both via email and a web-based submission form.
We heard from 24 witnesses including sufferers, regulators, anti-microbial resistance experts,
the pharmacy and medical peak bodies and Aboriginal health experts. A fact-finding trip to
Brisbane enabled us to speak to participating pharmacists in their pharmacies and understand
first-hand the customer and pharmacist’s experience of the program. The committee also
heard from consumers in Queensland as well as health regulators and conducted an informal
meeting with Queensland’s Chief Allied Health Officer.
The evidence received by the committee showed strong support for such a model in South
Australia, both from UTI sufferers and pharmacists. The committee took its time to listen to
those who expressed concerns regarding a UTI pharmacy service, and we have taken their
apprehensions into consideration in informing the recommendations.
Based on this evidence, the committee recommends that antibiotic medication to treat UTIs is
made available from pharmacists in South Australia under a model similar to Queensland’s
Urinary Tract Infection Pharmacy Service. The committee has made 29 recommendations to
ensure this service is safe and effective, is only available to those who meet appropriate
criteria, and is only provided by pharmacists who have undertaken additional training.
The committee considers this service will complement existing health services – namely that
offered by South Australian GPs. This service is not designed to replace GPs but rather to
provide women an additional avenue for safe and prompt treatment. Crucially, under the
proposed model, patients presenting to pharmacists who are not likely to be suffering a UTI
or who have complicating factors, will be referred to a GP for further assessment. Men,
children, and people aged over 65 will be ineligible for the service.