Evidence-Based Recommendations for Diagnosing and Treating Uncomplicated Urinary Tract Infections

To address best practices on outpatient diagnosis and treatment of urinary tract infections (UTIs) in light of concern about increasing antibiotic resistance, researchers conducted an evidence review of 44 randomized, controlled trials; observational cohort studies; and systematic reviews. These studies focused largely on uncomplicated UTIs in younger women (age, ≤65). Key findings from the evidence review are:

• UTIs can be diagnosed in patients without known anatomic urinary tract abnormalities, recent urinary tract instrumentation, or systemic illness if they exhibit at least two of three cardinal symptoms — dysuria, urgency, or frequency — along with absence of vaginal discharge.

• Neither urine dipstick testing for leukocyte esterase nor uri…