In elderly patients without localizing genitourinary symptoms or other systemic signs of infection, whether catheterized or not, the presence of delirium, increased falls, dizziness, altered behavior or decreased appetite do NOT warrant collection of a urine culture and urinalysis for assessment for UTI.
Urine culture and susceptibility and urinalysis testing are NOT necessary or beneficial in healthy, non-pregnant, premenopausal, non-diabetic women with acute cystitis (at least 2 of 3 cardinal symptoms – dysuria, urgency or frequency) and NO vaginal discharge without functional or anatomical abnormalities of the urinary tract.
Always obtain a culture for the following patients:
Patients with sign and symptoms of pyelonephritis
Premenopausal adult females with recurrent cystitis
Patients with complicated urinary tract infections (i.e. structural abnormality, obstruction, recent urologic procedure, male sex, immunosuppression, poorly controlled diabetes, spinal cord injury or catheterization)
Urine cultures should NOT be obtained for:
Elderly patients with an abnormal urinalysis without UTI symptoms
Cloudy/foul-smelling urine without UTI symptoms
Insertion or replacement of a urinary catheter
Routine screening or standing orders
Test of cure unless persistent or recurrent symptoms or pregnant