Luti in women under 65 pathway
Management of suspected bacterial lower urinary tract infection (LUTI) (SIGN)
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Urinary symptoms
(dysuria, frequency, urgency, visible haematuria, nocturia).
(dysuria, frequency, urgency, visible haematuria, nocturia).
Single urinary symptom
Two or more urinary symptoms
Any urinary symptoms in combination with new onset vaginal irritation or discharge
Perform urinary dipstick test for nitrites to confirm bacteriuria
Positive
Dipstick test result
Negative
Provide self-care advice
(see below)
Advise the patient to return if the symptom fails to improve
(see below)
Advise the patient to return if the symptom fails to improve
Provide self-care advice
(see below)
In patients that describe their symptoms as mild consider NSAIDs as first-line treatment.
In patients with moderate to severe symptoms consider NSAIDs an an alternative to an antibiotic following a discussion of risks and benefits.
(see below)
In patients that describe their symptoms as mild consider NSAIDs as first-line treatment.
In patients with moderate to severe symptoms consider NSAIDs an an alternative to an antibiotic following a discussion of risks and benefits.
Provide self-care advice
(see below)
Consider sending a urine specimen for culture to inform the diagnosis.
(see below)
Consider sending a urine specimen for culture to inform the diagnosis.
Explore STIs, urethritis and other causes of symptoms to rule out conditions that present in similar ways to uncomplicated UTI.
When antibiotics are required prescribe a 3-day course of a narrow spectrum antibiotic (following local drug guidelines).
Send a urine specimen for culture if the patient has a history of resistant urinary isolates, has taken any antibiotics in the past six months or fails to respond to empirical antibiotics.
Self-care advice for all women experiencing urinary symptoms
- Hydration
- Symptomatic relief
(paracetamol or ibuprofen) - Voiding behaviour
- Personal hygiene