Urinary Tract Infections (UTI) in Non-pregnant Adults

Urinary Tract Infections (UTI) in Non-pregnant Adults

Clinical Key Points

  • New onset or worsening urgency
  • Dysuria
  • Incontinence
  • Fever
  • Rigors
  • Altered mental status
  • Malaise
  • Flank pain
  • Costovertebral angle tenderness
  • Acute hematuria
  • Pelvic discomfort

Malodorous/cloudy urine alone is NOT a sign/symptom of UTI and is NOT an indication for urine cultures

  • Should NOT be treated EXCEPT in pregnancy or prior to urologic/gynecologic surgery
  • REQUIRES clinical assessment to RULE OUT:
    • Dehydration
    • Adverse effect of new medication
    • Trauma
    • Hypoxia
    • Hypoglycemia
    • Other infection

Urine Cultures should ALWAYS be collected mid-stream or by in/out catheter

  • Frequent and or prolonged hospital admissions
  • Invasive devices, prior surgeries, mechanical ventilation
  • Advanced age and residence in care facility
  • Frequent and or recent (within 30 day) antibiotic use
  • Recurrent UTIs


  • Premenopausal female with no urological abnormalities or co-morbidities
  • All males

  • Females 65 yrs and older or with urologic abnormalities or co-morbidities