Urinary tract infections not so easy to diagnose

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Goodfellow Gems

Urinary tract infections not so easy to diagnose

A recent Tools for Practice1 notes “Individual symptoms and leukocytes on urinalysis generally add little to diagnosis. The presence of nitrites increases the probability of UTI, but their absence means little. About 60% of women presenting to primary care with possible UTI have a UTI (before any history, physical or testing). A single urine culture likely misses cases, meaning prevalence is even higher.”

Often, dysuria without frequency can be herpes simplex, so a genital exam can be helpful. In the end, if unsure, then treating with antibiotics may be an option. In Auckland, this is now Macrobid 100 mg BD (i.e. modified release; on most PMS, use trade name to get the correct compound) for 5 to 7 days. 

Reference:

  1. Is booking an urgent UTI appointment the best sign of a UTI? Tools for Practice # 324. View

Gems are chosen by the Goodfellow director Dr Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice.



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