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Empiric treatment of cystitis with antibiotics (a common guideline recommendation) results in as many as 40% of symptomatic women unnecessarily receiving antibiotics (as confirmed by their negative culture results). A decision tool that could predict a positive culture would allow treatment to be more specific, to reduce costs, and to avoid the side effects of antibiotics.
Researchers tested a four-item decision tool in 422 nonpregnant women older than 16 from community-based practices throughout Canada. The four elements were symptoms for 1 day (vs. >1 day), dysuria, presence of leukocytes in greater than trace amounts (by dipstick), and presence of nitrates in any amount (by dipstick). Urine culture was performed for all patients. Duration…