UTI women uncomplicated - not pregnant or catheterised
do not routinely send urine for culture in uncomplicated UTI
symptoms
treatment
when to send for culture
impaired renal function
abnormal urinary tract - neurogenic bladder
immunosupression
frequency
urgency
dysuria
suprapubic pain
lethargy
pain relief eg paraccetamol or ibuprofen
abx to all symptomatic patients
trimethoprim 200mg BD for three days
nitrofuratoin - 50mg QDS or 100mg M/D BD 3 days
consider longer course 5-10 days abx for those whose urine would be cultured
delayed treatment can be advised in otherwise well patients - push fluids
do not advise cranberry juice
follow up
Advise all women to seek medical attention if they develop fever, loin pain, or do not respond to treatment with the first-choice antibiotic.
For women with mild symptoms who are not catheterized, dipstick test the urine for leucocyte esterase and nitrite to look for further evidence of UTI
if the leucocyte esterase test alone is positive, a UTI is moderately likely
If the nitrite test is positive, with or without a positive leucocyte esterase test, a UTI is highly likely
For women with moderate or severe symptoms, with or without a catheter, make a working diagnosis of UTI without testing the urine with a dipstick