Urinary tract infection is more common in women than in men; when it occurs in men there is frequently an underlying abnormality of the renal tract.
- If a patient presents with clinical signs/symptoms of UTI or urosepsis please ensure that an MSU sample is sent for routine microscopy and culture.
- Please DO NOT treat patients for UTI purely on the basis of a positive urine dip result.
- Urine dip test is only useful to RULE OUT urinary tract infection.
- If patient has recurrent UTIs, please discuss that case with Microbiology and DO NOT prescribe prophylactic antibiotics.
UTI in Pregnancy
- Send MSU for culture
- Treat for 7 days with an oral antibiotic according to results of sensitivity tests.
Antibiotics that are regarded as suitable for use in pregnancy include: cefalexin and amoxicillin (once sensitivity results are available). Nitrofurantoin; do not use close to term as can cause haemolysis in patients with G6PD deficiency. Foetal erythrocytes have little reduced glutatione and there is a theoretical possibility that haemolysis may occur. Trimethoprim; do not use in first trimester or if the pregnant patient is folate-deficient, has a predisposition to folate-deficiency, or is taking another folate antagonist such as an anti-epileptic of proguanil.
- A complicated UTI is defined as a UTI in the presence of an underlying structural abnormality of the renal tract.
- Urine cultures should be sent to guide targeted antibiotic therapy in all cases.
- Patients with a urinary catheter in-situ may have asymptomatic bacteriuria.
- Unless patient is symptomatic of catheter-associated UTI or systemically septic please DO NOT institure empiric antibiotic treatment.
- DO NOT initialte antibiotic treatment based on a positive dipstick result only.
- Please ensure that:
- catheters are only inserted for appropriate indications
- catheters are in-situ for only as long as needed
- catheter insertion is undertaken with aseptic technique
- following catheter insertion, a closed drainage system is maintained
- unobstructed urine flow is maintained
- hand hygeine and standard IP&C precautions are taken when handling the catheter.
Antimicrobial selection should be based upon the culture results when available