A premature termination was decided following the publication of the order authorizing the pharmacist to dispense antibiotics for simple cystitis in women. Thus the experimental practice of the study joins very strongly with the new practice.

Every year, between 4 and 6 million French people are affected by a urinary infection; the vast majority of these are women. Although the diagnosis of an uncomplicated urinary tract infection is simple to make, it requires prompt medical management to relieve the symptoms. The lack of immediate of a physician can slow down the management of patients affected by this condition, and lead to an inappropriate referral of patients to the emergency services.

Because of their wide availability, accessibility, and geographical distribution throughout the country, pharmacists are primary health care professionals who are regularly called upon to respond to patients with this type of infection.

A national protocol exists in France, but it is very difficult to apply. The PharmaCyst' study aims to evaluate its application in community pharmacies.

Inclusion Criteria:

• Female

• Age ≥ 18 and <65 years

• Patient with less than 3 days of simple urinary tract infection symptoms:

  • Burning, pain on urination
  • Dysuria
  • Pollakiuria
  • Urinary urgency

• Patient affiliated or beneficiary of a social insurance

• Patient having signed an informed consent.

Exclusion Criteria:

• More than 3 cystitis in the last 12 months;
• Last cystitis less than 15 days old;
• Presence of fever;
• Presence of back pain;
• Presence of a functional or organic anomaly of the urinary tract (bladder residue, vesico-ureteral reflux, lithiasis, tumor);
• Pruritus or vaginal discharge;
• Vomiting, diarrhea, diffuse abdominal pain;
• Risk factors for C3G-resistant enterobacteria infection (grade B):
• Exposure to an antibiotic (amoxicillin-clavulanic acid, C2G, C3G, fluoroquinolones) within the previous 3 months;
• A nosocomial or healthcare-associated infection;
• A history of colonization or infection with C3G-resistant enterobacteria within the last 3 months;
• A trip to a foreign country within the last 3 months in known geographical areas at risk (in particular the Indian subcontinent, South-East Asia, the Middle East and North Africa, the Mediterranean basin);
• Hospitalization within 3 months;
• Hospitalization within 6 months for UTI;
• Known severe renal insufficiency (creatinine clearance < 30 mL/min);
• Severe immunosuppression or immunosuppressive treatments;
• Contraindications to drugs planned for experimental management (pivmecillinam and fosfomycin) or combination of drugs not recommended;
• Pregnant women (confirmed or suspected pregnancy), breastfeeding women or women in labour;
• Person deprived of liberty by judicial or administrative decision;
• Person under forced psychiatric care;
• Person admitted to a health or social institution for purposes other than research;
• Person subject to a legal protection measure;
• A person who is unable to give consent.

Gender identity

Data will be shared upon reasonable request. Only de-identified data will be shared. Any data collected during the study may be shared. The protocol will be shared initially. Other documents may be shared at a later date upon request (e.g., the CRF to allow a collaborator to select the data they wish to access). The recipients of the data will be researchers. The data will be available for any purpose deemed relevant by the study investigator, based on a protocol provided by the requester, after verification of the obtaining of regulatory approvals, including the favorable opinion of an ethics committee.

The data will be shared after signing a negotiated data transfer agreement ( data access agreement), for the duration specified in the agreement.

The data will be made available via secure transfer (sharing platform approved by the university hospital: BlueFiles or Oodrive).