Practice tips

• Most symptomatic UTIs are acute cystitis occurring in sexually active women with anatomically normal urinary tracts.

• A clinical diagnosis based on experience, plus positive nitrite dipstick test and the finding of pyuria by office microscopy will generally enable immediate curative treatment.

• A 3-day course of trimethoprim 300 mg daily for 3 days is a suitable first choice for acute uncomplicated cystitis in women.

• Avoid overinvestigation of patients in whom there is a low likelihood of demonstrating structural abnormalities.

• In males the prostate is the most common source of recurrent UTI.

• Urinary tract infection is commonly associated with microscopic haematuria (occasionally macroscopic haematuria).

• Persisting haematuria should be investigated.

• Due to the rising level of E. coli resistance, amoxycillin is no longer recommended unless susceptibility of the organism is proven. 5

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