In non-pregnant women with typical symptoms, treatment can often be started on symptoms and local resistance patterns. In men, children, pregnant women, older people with unclear symptoms, and anyone with recurrent or treatment-failure infection, send a urine culture first, so that treatment can be targeted.
Do not treat asymptomatic bacteriuria in non-pregnant adults.
- Send urine for culture before antibiotics in men, children and pregnant women.
- Also culture in recurrent infection, treatment failure and complicated cases.
- Do not treat bacteriuria without symptoms in non-pregnant adults.
- Review the choice of antibiotic against local resistance data when the result returns.
- Give safety-net advice on fever, flank pain and worsening symptoms.
Why it matters
Culture is cheap, and without it the next course of antibiotics is a guess.
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