My Pet Peeves – Management of UTI’s
It’s no secret that I work with a lot of geriatric patients. These things have been on my mind lately about the management of UTI’s, so just wanted to share them.
- With rare exception, asymptomatic bacteriuria (ASB) should not be treated. ASB is defined as “isolation of a specified quantitative count of bacteria in an appropriately collected urine specimen from an individual without symptoms or signs of urinary tract infection” via Uptodate.
- Cloudy urine alone is not a reason to get a urinalysis. I see this frequently from nurses who are legitimately trying to do the right thing, but it leads to increased risk of adverse effects from medications as well as risking increasing problems with future resistance. A few other potential signs of infection include fever, pain in the abdomen or back, change in cognition (especially in the elderly), or painful urination.
- About once or twice a year I see an order for a routine UA to be performed to detect bacteria in the urine. A positive result in this situation again leads to potential overuse of antibiotics and put patients at risk of increased resistance as well as adverse effects and drug interaction. No symptoms of infection, no treatment!
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