Diagnosis of UTI requires a combination of reliable clinical signs and symptoms AND a positive urine culture result.
Do NOT send urine for culture or perform urine dipstick testing in patients who are asymptomatic.
Asymptomatic bacteriuria (abnormal dipstick or urine culture without signs/symptoms of UTI) in the institutionalized elderly is common. Antibiotic therapy in these cases offers no benefit and increases harm. (e.g. side effects from antibiotics, antibiotic resistance, Clostridium difficile infection).
Empiric therapy for UTI can be considered if the patient has clinical signs and symptoms consistent with a UTI and appropriate urine specimens (midstream or in/out catheter) have been obtained and sent for urinalysis and culture
Interpreting Laboratory Results