Be #urosceptical

Ditch the Dipstick – for patients >65Yrs or Catheterised!

Approx. 50% of over 65’s and most of those with catheters have asymptomatic bacteriuria. The patient will not benefit from treatment and often gives us premature closure (i.e. we blame a fictitious UTI for the patients symptoms and stop thinking).

Recommendation

  1. Think Sepsis! – If the patient is septic treat as guidance
  2. Look for Signs & Symps of UTI – us the indicators below
    • New dysuria (alone)
    • OR 2 of the following:
      • Temp 1.5°C above their norm (twice in 12hr) OR Hypothermia
      • New frequency/urgency
      • New incontinence
      • New/Worsening delirium/debility*
      • New suprapubic/flank pain
      • Visible haematuria
  3. Consider UTI in older patients with: pyrexia, hypothermia, abnormal WCC or CRP AND no alternative cause for these.

*Confusion does not always mean infection. Consider other causes such as dehydration, constipation, medication etc. 

Management

  • Only treat based on documented clinical signs and symptoms.
  • Send an MSU for culture before commencing antibiotics.
  • Follow antibiotic guidance

 

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