Buying health services for local people

If you have recently travelled from Wuhan, China or are looking for information on the coronavirus outbreak please go to our page on coronavirus or the information on GOV.UK

en English
en English

Urinary Tract Infection (UTI) – Diagnosing (GP information)

Please note:

To help influence reporting, it would be useful if you could please include on the request form symptoms the patient is experiencing rather than sending a request in labelled ‘Query UTI’.

Urinary Symptoms in Adult Women <65 years old do not culture routinely

In sexually active young men and women with urinary symptoms consider Chlamydia trachomatis

Urine culture in women and men > 65 years

  • Do not send urine for culture in asymptomatic elderly with positivedipsticks
  • Only send urine for culture if two or more signs of infection, especially dysuria,fever >38◦ or new incontinence
  • Do not treat asymptomatic bacteriuria in the elderly, as it is very common
  • Treating does not reduce mortality or prevent symptomatic episodes, butincreases side effects & antibiotic resistance

Urine culture in women and men with catheters

  • Do not treat asymptomatic bacteriuria in those with indwelling catheters,as bacteriuria is very common and antibiotics increase side effects andantibiotic resistance
  • Treatment does not reduce mortality or prevent symptomatic episodes, butincrease side effects and antibiotic resistance
  • Only send urine for culture in catheterised if features of symptomatic infection.However always: - exclude other sources of infection - check that the catheter drains correctly and is not blocked - consider need for continued catheterisation - if the catheter has been in place for more than 7 days, consider changing it before/when starting antibiotic treatment
  • Do not give antibiotic prophylaxis for catheter changes unless history ofsymptomatic UTIs due to catheter change

When else should I send a urine sample for culture?

  • Pregnancy – if symptomatic for investigation of possible UTI. In all at firstantenatal visit – as asymptomatic bacteriuria is associated with pyelonephritisand premature delivery
  • Suspected pyelonephritis (loin pain and fever)
  • Suspected UTI in men
  • Failed antibiotic treatment or persistent symptoms
  • Recurrent UTI, abnormalities of genitourinary tract, renal impairment –more likely to have a resistant strain

There’s more detailed information in this Quick Reference Guide for Primary Care.

en English
X