COLUMBUS AIR FORCE BASE, Miss. -- Capt. Hailey Faist, MD, 14th Medical Group flight surgeon, noticed an issue with the limited list of approved medications to treat Urinary Tract Infections (UTIs).
Urinary Tract Infections are a common medical condition that disproportionately impacts females more than males. The only approved medication to treat flyers with UTIs was Trimethoprim-Sulfamethoxazole (Bactrim), which is a medication most medical providers reserve for more severe cases.
“I saw none of the most commonly prescribed medications to treat UTIs were approved for flyers, and that is when I asked the question,” said Dr. Faist.
If flight surgeons used the medically recommended, first-choice medications to treat female flyers with UTIs, they would not be able to fly for up to 5 days in compliance with the prior aeromedical regulations.
“If instructor pilots or student pilots are down for 5 days, they would miss a whole week of training, which is unacceptable at a pilot training base,” said Faist.
Dr. Faist brought this concern to U.S. Air Force Capt. James Bates, DO, 14th Medical Group Aerospace Medicine chief (SGP).
“After Dr. Faist asked the question, I went on temporary duty at Wright-Patterson AFB with other Aerospace Medicine Chiefs,” said Bates. “Col. Micah Schmidt, the Chief of Medical Standards for the Air Force was a guest speaker. I asked him the question and he explained the process to add new medications to the Approved Aircrew Medication List. "
After speaking with Col Schmidt, Dr. Bates began to write a proposal.
“We compared data statistically showing 33 percent of active duty females are diagnosed with UTIs compared to 3 percent of males. We then discussed the aeromedical risk of approving the proposed preferred medication,” said Bates.
Bates then presented a virtual meeting across all Aeromedical Standards for the Air Force. The meeting included members from Air Force Medical Standards, Major Command SGPs, specialist physicians, and representatives from the Federal Aviation Administration.
“During that meeting the proposal was verbally approved,” said Bates. “Just last week they pushed out the updated approved aircrew medication list and the three medications we proposed were on it.”
With the updated list of approved medications: Nitrofurantoin (Macrobid), Fosfomycin, and Phenazopyridine (Azo), pilots can now return to flying after their symptoms have improved and flight surgeons have more prescribing options to treat this common medical condition.
“Macrobid is the first choice for treating UTIs in most medical settings, Fosfomycin is a one-time dose antibiotic, and Phenazopyridine (Azo) is used for symptomatic relief,” said Faist.
Bates hopes this will reduce barriers for flyers to seek medical care.
“Previously, if a female was in her final block of training and she started feeling symptoms of a UTI, there would be temptation for her not to come in and get help, knowing she could be down for at least a week.” said Bates.
“This directly impacts Air Force readiness,” said Faist. “It gets flyers back to their job much faster with a pretty common medical issue that disproportionately affects females.”