NICE released new guidelines in Oct 18 on antimicrobial prescribing in lower urinary tract infection (UTI). Public Health England (PHE) has guidelines on the diagnosis and management of UTI, which were update shortly afterwards. There is separate advice on antibiotic prescribing in pyelonephritis, but this doesn’t change practice.
The PHE guideline especially is really useful. It gives a very clear, evidenced based way of deciding who needs investigating (ie dipstix or culture) and who needs treating. I suspect I have been overtreating.
For me, the single biggest learning point was that we shouldn’t be dipping urine in the over 65s. Half of the over 65s will have asymptomatic bacteruria which will show up on a dipstix as a false positive.
